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HCIC.Net
For Sponsor/Exhibitors
For Speakers
November 5-8, 2023
Los Angeles, CA
Agenda
Exhibitors / Sponsors
Reg and Attendee Info
Venue
Webinars
Podcasts
Speaker Proposal Application
Healthcare Internet Conference
/
Webinars
/
Speaker Proposal Application
Please complete all fields in this form
(co-presenter information is optional only if you are a provider)
. A Greystone associate will contact you to finalize dates, times, topic etc.
Please select the level in which you are interested.
Explanation of Levels
Basic Backstage Pass
Exclusive Backstage Pass
Call Center Webinar
Primary Presenter contact information:
First Name
*
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Last Name
*
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Title
*
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Organization
*
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Address
*
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City
*
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State
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Zip
*
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Phone
*
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Fax
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Email
*
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Biographic brief for Primary Presenter
*
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limit text to 75 words
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Co-Presenter contact information:
(optional)
Full Name
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Title
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Organization
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Address
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City
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State
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Zip
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Phone
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Fax
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Email
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Biographic brief for Co-Presenter, if applicable
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limit text to 75 words
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Session information:
Presentation Category
*
(please select the category you feel best fits your presentation)
Consumer Engagement
Content Strategy
Tools, Technology and Analytics
Digital Strategic Planning
Social Media & Mobile
Branding, Design & Usability
Digital Marketing and Advertising
Other
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Session Title
*
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Abstract of the presentation
*
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limit to 75 words
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Three learning objectives
*
:
1.
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2.
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3.
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Additional Information
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Use this space for any additional information that you feel may be valuable for the selection committee. Limit to 100 words.
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Agree to terms*
I acknowledge that I have read and agree to the terms and privacy policy.
Electronic Signature
*
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initials
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Date
*
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