Thank you for considering the Georgia Department of Community Health for your next conference. To request a speaker, please complete and return this form. All fields must be completed for consideration. Those requests with at least a 30-day advance notice will be given priority attention. Someone from the Communications team will follow up with event organizers.

Include event title, date, relevant links, and location (below).
Event Location
Event Coordinator
Office Telephone
Do you have a specific DCH speaker you’d like to request?
If uncertain, provide suggestions based on conference themes.
Examples include: keynote; remarks at podium with slides; fireside chat; breakout session, etc.
Will media be invited?