Thank you for presenting at our #CAComingTogether Conference Series - Continuing the Conversation on Behavioral Health. The conference is scheduled for Thursday, 10/7/21 at 9 a.m. (PDT). Please complete this short survey to help us prepare for the conference. If you have any questions, please email our Conference team at IntegratedConfHelp@gmail.com

Please complete the survey by 9/15 to allow us time to update the conference website, promote the event, and distribute the presenter packages.

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* 1. Please enter your primary contact info

(Note: Contact info will be used only by conference staff to connect with presenters, it will not be shared with the conference attendees.)

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* 2. If applicable, please enter your secondary contact info (colleague, assistant, etc.) who should also receive Conference links for your session.

(Note: Contact info will be used only by conference staff to connect with presenters, it will not be shared with the conference attendees.)

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* 3. Would you like to receive a full complimentary presenter package with a ring light and lavalier microphone?

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* 4. What is the title of your presentation? (If unknown, what is the topic?)

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* 5. Please provide a two-sentence summary of the presentation. 

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* 6. Will your presentation be live or recorded? 

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* 7. If your presentation will be pre-recorded, when will your panel be recording?

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* 8. Will you have a PowerPoint presentation or materials to share?

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* 9. Please submit a headshot to be used on our presenter information page and social media.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 10. Please submit a short (100 word) bio to be used on our presenter information page and on social media.

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* 11. "If you use social media, please share your handle (FB, Twitter, Instagram)

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* 12. Do we have permission to share photos and quotes from you during the conference and to promote the conference? 

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