Thank you for considering Six Dimensions in your upcoming event. We look forward to partnering with your organization in any capacity that we can. Please complete this form to help us understand how we can support your event.

Allow us up to 7-10 business days to respond to your request. We look forward to working with you!

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* 1. Organization name

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* 2. Organization City and State

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* 3. Name

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* 4. Email Address

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* 5. Phone Number

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* 6. When is the event?

Date

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* 7. Event start time

Time

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* 8. Event end time

Time

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* 9. Is this event face-to-face or virtual?

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* 10. Location of Event

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* 11. What is the purpose and goal of this event?

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* 12. Has your organization hosted this event before?

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* 13. If yes, has Six Dimensions participated in any capacity?

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* 14. What is the expected attendance?

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* 15. Who is the expected demographic (race/ethnicity and gender) and audience (new/expecting mothers, birth workers, healthcare workers, advocacy groups, etc.)?

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* 16. How can Six Dimensions support your event?

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* 17. Please include any request details. (educational resources, pregancy journals, blood pressure cuffs, etc.)

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* 18. Please include any marketing materials.

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