Our Policies

Speakers' Bureau Registration

Navicent Health is proud to sponsor a Speaker’s Bureau to provide health education information to the Central Georgia community.

To see a list of topics we speak about, please click here.

To see our Speaker Bureau Guidelines, please click here.

Please complete all areas:

Event Information:

(1 only please)

Contact Information:

Disclaimer:

I understand this request is for a Medical Center sponsored Speaker's Bureau that needs to be reviewed and approved. This request can be denied for lack of staffing, sponsorship, conflicts of interest/time, or modified according to what can be provided by the Medical Center. I am aware all requests for speakers outside a 25-mile radius from the Medical Center will be denied. I have been notified of the 72-hour cancellation policy and agree to contact the Medical Center if we need to cancel this event. I also understand that if I have not received a confirmation of acceptance by the Medical Center I cannot assume a speaker will be assigned without contacting the Community Health Education Department at 478-633-6349. Please allow a minimum of one week to process your request.

Electronic Signature:

By typing my name here, I agree that I have read and understand the Speaker's Bureau Guidelines and Disclaimer above:

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Terms of Use

I give permission for Navicent to use the information I supply on this form to fulfill my request for a physician appointment and to contact me for that purpose.
I certify that I am at least 18 years old and I acknowledge that I have read and accept these terms and agree to use this form to request a physician appointment.
Because we value your privacy, your personal information will not be used other than to schedule an appointment.