| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Your Contact Information









Please complete the information below for each speaker/presenter. 
If there will be more than two speakers for this webinar, please send the additional information to support@healthtecdl.org and reference the title of this webinar in the email. 
Speaker #1 Information












If applicable, Speaker #2 Information












Event Information







Event Scheduling
Please select three dates/times that you are available to hold the event.






Rehearsal Scheduling
A rehearsal is required if the speaker(s) will be presenting remotely to ensure the technology is working properly. Please choose a time for the rehearsal below.

If the speaker(s) will be presenting at Healthcare Georgia Foundation, rehearsal will happen 30-60 minutes before the webinar.