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Schedule a Meeting or Speaking Engagement


Office of the Patient Advocate (OPA) staff are available to speak about patients' rights at events such as health care provider meetings, community forums, patient support groups, places of worship, local community centers, senior centers, union meetings, and employee meetings. Presentations are available in various languages through interpreters including sign language interpreters.

Fill out the following form to request a speaking engagement or meeting with an OPA staff person.

If you wish to schedule OPA staff to participate in your community event, please fill out the form below.

*Indicates A Required Field


1. Event information:

Name or group requesting:*
Type of request:*
Date of event:*
Time of event:*
Location:*
Expected number of people attending:*
Additional information:*
2. Contact information

Name:*
Address:*

City:*
State:*
Zip code:*
 -
Phone number:*
()
Email address:*
3. Security code


Please type the confirmation code in the picture below into the text box.*
 

                           

 

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