Seminar Request - KP International | Kaiser Permanente International

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Today's Date*

Organizer's Contact Information

Your name*

First Last

Job title*

Organization*

City*

Country*

Email*

Please describe your role in this visit. Are you a consultant, study tour leader, government official, or employee of the sponsoring company?*

How did you hear about Kaiser Permanente?*

KP International email
KP International website
A colleague in my country
A previous visit to Kaiser Permanente
Someone I know at Kaiser Permanente
A Kaiser Permanente speaker at a conference
International Federation of Health Plans (iFHP)
Other

Have you visited Kaiser Permanente before? Please briefly mention where and when.

Participant Information

Please give the total number of people who will attend the seminar, including any tour guides or interpreters.*

Please list the country or countries the participants are from.*

What is the English language level of the participants? (Choose more than one response if applicable.)*

Advanced level or native speaker
High level
Intermediate level
Beginner level or no English

Are you bringing an interpreter? If so, will the interpretation be simultaneous (with headsets) or sequential?*

Please identify the type(s) of organization(s) the participants work for. (Check all that apply.)*

Health plan
Hospital or clinic (inpatient or outpatient facility)
Government
Independent association
Consultant
Vendor
Investor
University

Please describe the participants' learning objectives for the seminar.*

Which other companies or conferences will the participants visit during their stay in the United States?*

Seminar Options

Please select which offering the participants are interested in.*

Introductory seminar (two-hour general overview of the KP model, with questions and answers)
Advanced seminar (general overview with a deeper dive into a specialized topic; length of seminar may vary)
Not sure / unknown

Which location(s) are you considering for the seminar? You may indicate more than one response. (Please note that hotels should be booked well in advance.)*

Oakland, California (San Francisco Bay Area)
Southern California (Los Angeles area)
Washington, DC
Not sure / unknown

First choice date for the seminar*

Second choice date for the seminar*

Additional comments or questions