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2022 IHS Virtual Partnership Conference
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2022 IHS Virtual Partnership Conference
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Speaker Registration Form
Speaker Registration Form
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Mandatory Field
Prefix
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Mr.
Mrs.
Ms.
Other
First Name
Last Name
Suffix
Job Title
Biography
Session Title 1
Are you the Panel Lead?
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Yes
No
Please add the session abstract
Are you presenting in multiple sessions?
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Yes
No
Session 2 Title
Are you the Panel Lead of Session 2?
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Yes
No
Please add the session abstract of Session 2
Session 3 Title
Are you the Panel Lead of Session 3?
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Yes
No
Please add the session abstract of Session 3
Session 4 Title
Are you the Panel Lead of Session 4?
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Yes
No
Please add the session abstract of Session 4
Session 5 Title
Are you the Panel Lead of Session 5?
Please select
Yes
No
Please add the session abstract of Session 5
Company/Tribe/Organization
Business Address 1
Business Address 2
Business Address 3
City
State
Postal Code
Phone Number
Email
Repeat Email
Registration type
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IHS
Tribal/Tribal Organization
Urban
Other Federal
Other Vendor
Other
Other
If you are a Tribal employee, please indicate the Tribe
IHS Area
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Alaska
Albuquerque
Bemidji
Billings
California
Great Plains
Nashville
Navajo
Oklahoma City
Phoenix
Portland
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Headquarters
Principal track
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Business Office / Finance
Health Information Management
Information Technology
Purchased/Referred Care
Tribal / Urban
Do you require ADA assistance?
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Yes
No
Sub-categories
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Audio
Visual
Other
Other
Are you attending for AAPC CEUs?
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Yes
No
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