Skip to Main Content
California Government Website
Facebook
YouTube
X (former Twitter)
LinkedIn
About Us
Careers
Contact Us
Site
Settings
Search
Google Translate Settings
Default
High Contrast
Reset
Increase Font Size
Font
Increase
Decrease Font Size
Font
Decrease
×
×
Menu
Steps to
File a Complaint
File a Complaint
Independent Medical Review/Complaint Forms
How to File a Complaint with Your Health Plan
Provider Complaint Against a Plan
Frequently Asked Questions
Health Care in California
Health Care in California
Choose the Right Plan
Low or No-Income Options and The Uninsured
Types of Coverage
Types of Plans
I'm Insured, Now What?
Get the Best Care
Your Health Care Rights
Resources for Health Care Providers
Data & Research
Data & Research
Search Independent Medical Review Decisions
Premium Rate Review
Health Plan Dashboard
Enforcement Actions
Consumer Complaints and IMRs
Financial Stability
Licensing & Reporting
Licensing & Reporting
Health Plan Licensing
Filing and Reporting Process
Submit Health Plan Filings
Risk Bearing Organizations
Health Plan Compliance/Medical Survey
View Financial Examination Reports
Submit Financial Reports
Pharmacy Benefit Manager Registration
Individual and Small Group Product Filings
Employee Assistance Program
Laws & Regulations
Laws & Regulations
Enforcement Action Database
Administrative Actions and Decisions
Director's Letters and Opinions
Resources
Resources
Newsroom
Public Records Requests
Public Meetings
Reports
Consumer Participation Program
Home
Contact Us
Speaker/Event Request
Speaker/Event Request
Speaker Event Request
Please complete and submit the form below to request a speaker or Department representative to attend your upcoming event. Your submission will be reviewed and you will be contacted by a representative of the Department.
Required fields are identified with an asterisk
(*)
Request Date
:
*
Your Organization:
Sponsoring Organization
:
*
Type of Organization
:
*
Contact Name
:
*
Contact Phone
:
*
Contact E-mail
:
*
Website
:
*
Your Program:
Date of Program
:
*
Time of Program
:
*
Name of Program
:
*
Theme /Purpose of Program
:
*
Location of Program
:
*
Proposed Topic
:
*
Presentation Format (Panel, Speech, Roundtable, Tabling, Etc.)
:
*
Length of Speaker’s Presentation
:
*
Your Audience Composition:
Size of Audience
:
*
Language needs?
*
Audience Composition (consumers, stakeholders, providers, etc.)
:
*
Additional Information?
g-recaptcha-response
Click to submit the request form