CAMSS Annual Education Speaker Pre-Screening Form 2026

On behalf of the CAMSS Board, thank you for your interest in speaking at our educational forum.

New MSP's

Seasoned MSP's

Payer Enrollment Professionals

CVO

Medical Staff Leaders

Administrative Leaders

Other (please specify)

First Name, Last Name, Degree:

Company/Institution Name:

E-mail Address:

Mobile Phone #:

Preferred Mailing Address Line 1:

Preferred Mailing Address City, State, Zip Code:

Administrative Assistance Name (If applicable):

Administrative Assistance E-mail (if applicable):

Administrative Assistance Phone (if applicable):

Yes