2017 HIT Summit Speaker/Session Nomination

2017 Theme: What’s next in healthcare? Initiating collaboration and innovation in our communities

Nominations received after August 1st may be considered for next year's summit.

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* 1. Nominated Speaker/Panelist/Moderator 1 Contact Information

Name

Company

Email Address

Phone Number

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* 2. Type of Speaker

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* 3. Why are you suggesting this speaker/panelist/moderator?

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* 4. Nominated Speaker/Panelist/Moderator 2 Contact Information

Name

Company

Email Address

Phone Number

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* 5. Type of Speaker

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* 6. Why are your suggesting this speaker/panelist/moderator?

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* 7. What track are you submitting this session for?

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* 8. Session Title (100 Characters)

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* 9. What will be the key takeaways from the session?

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* 10. Description (You can upload this via a document below)

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* 11. Why should this proposal be selected for the 2017 Health IT Leadership Summit?

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* 12. Additional Materials

Please upload any additional materials that you want included for your proposal

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

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* 13. Feel free to provide link to any website(s) with recordings or transcripts of past speeches.

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* 14. Nominator Contact Information

Name

Company

Email Address

Phone Number