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Speaker Request Form

Before you begin: KP International primarily serves clients who are based outside the United States, and the presentation may be virtual or in person. If you are based within the United States and are interested in having a Kaiser Permanente speaker present at your event, virtually or in person, please visit this website instead.

  • Privacy Policy: Kaiser Permanente International may collect personal information that you voluntarily share with us (for example your name, email, job title, and employer). We use this information for business purposes including planning and marketing educational programs and speaking engagements. We do not share this information with third parties. We may add you to our mailing list for occasional newsletters, and you may unsubscribe at any time.
  • Thank you for your interest. This form is a preliminary tool for gathering information; it is not a confirmation of your speaking engagement. After you submit this form, we will email you to discuss the options.
  • MM slash DD slash YYYY

  • Your Contact Information

  • Goals of Your Event

  • Date and Logistics

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.
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