Speaker Request Form

Address

140 E. Town Street. Suite 1000
Columbus, OH 43215

Contact

614.224.4950

Please fill out the form below about your upcoming events. If you have any questions about the form or need assistance, please contact HPIO’s Director of Communications, Alana Clark-Kirk.

Name of your organization

Organization *

Contact Information

Name

Title

Email Address

Phone

Presentation Information

Date + Time

Location

Expected length of remarks

What topic(s) would you like HPIO to address?

Who is the expected audience?

How many people are you expecting?

Is the presentation part of a conference? If yes, will the presentation be a plenary, breakout or workshop? If breakout or workshop, how many other sessions are planned for the sam

Is the presentation part of a panel? If yes, how many other speakers are participating? What other speakers have confirmed their participation on the panel?

Are you able to provide an honorarium for this presentation?

Yes

Does this presentation require travel from Columbus, OH

Yes

Attend HPIO's 2026 Health Policy Summit on Aug. 26

The Summit will draw insights from HPIO’s 2026 Health Value Dashboard to focus attention on the factors that drive population health and healthcare spending and build momentum for policy priorities that lead to improved health and well-being for Ohioans.