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Health Affairs Events Speaker Information Form

If you are interested in speaking at one of our events please fill out the form below. A Health Affairs Events team member will contact you if an approved speaking slot becomes available.

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First Name*

Last Name*

Position Title*

Company/Organization*

Email*

Phone*

Brief Bio*

List 3 to 4 Topics of Expertise*

Prior Speaking Engagements (up to 10)*

Please verify your request*