Health Access Foundation - Event Request Form

Generally, events we post on our Advocacy Calendar are those that we hear about through our member organizations, advocates, and other groups interested in our mission.

We invite all organizations sponsoring events relating to health and budget issues to submit them to be posted on this calendar.

Please fill out the form below to send a request to have your event added to our calendar. Please don't forget to fill in each field with the appropriate details. Once submitted the staff here at Health Access will screen the events and add them to the calendar within 2 business days.

Please keep in mind that the purpose of this calendar is to inform people of Public Events, those where other advocates are welcomed to participate in.

Personal Information

First Name:
Last Name:
Email Address :
Organization Name:

Event Information

Date of Event:
Type of Event:	Other:
	Start Time:	End Time:
Location:	Building (if applicable)
	Address
	City
	State
	Zip

Title of Event:
Description of Event: Please give a brief description of the event.
Contact Info: Someone an individual can contact for more information
Sponsoring Organization: Who's organizing the event
Website Address: Optional