Healthy California Speaker Request Form
Please fill out the following information to request a speaker from the Healthy California campaign to discuss the Healthy California Act , SB 562 (Lara & Atkins), which will guarantee healthcare for all in California.
Type of Event
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Organizer
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Email
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Phone number
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Meeting Date
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DD
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YYYY
Meeting Location
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Number of Attendees Expected At Meeting:
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Meeting Start Time
Time
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Speaker Start Time
Time
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Is there time for Questions and Answer?
Time allotted to HealthyCA presenter (including Q & A)?
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Meeting purpose/type
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Has your organization endorsed SB 562?
Who is the audience?
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Is media invited?
Format?
If Panel, please list others invited to speak:
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Any other details we should be aware of?
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