Speaking AND Podcasts

Interested in having Dr. Shawntay Harris speak
at your facility (live or virtual) or on your podcast?

Please complete the request form below. We will respond within 3 days of submission.

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Provide the Organization's Full Name

Name

First

Last

Phone

Event Requested Date and Time Zone (Central Time Zone)

Please select the option that best represents the format of your event.

Who will be the primary audience in attendance? Select only one.

How many people are expected to attend?

Will you offer continuing education credits to attendees?

Is your organization able to cover the expenses?

Additional Comments