Welcome to the Department of Anesthesiology & Pain Medicine's Event Request Form. Our team is here to assist you in planning and executing your upcoming event. To ensure a successful event, please complete this survey to provide us with some details. 

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* 1. What is the title of your event?

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* 2. Proposed date and time?

Date
Time
Date
Time

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* 3. Alternative Dates for the Event?

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* 4. Does your event coincide with major religious holidays or significant cultural observances? 

Please refer to the following document provided by UofT to check if there are any conflicts: CLICK HERE

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* 5. Where will the event be held?

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* 6. If the event is to be held over Zoom, do you need administrative support from the department to manage the event?

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* 7. Who is the intended audience for your event

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* 8. If you already have a poster for your event, please upload it.

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

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* 9. Is the event open to the public or is it limited to persons appointed to the Department of Anesthesiology & Pain Medicine?

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* 10. If you need the communications team to create a poster, please upload any photos, graphics, or artwork related to the event that you would like to include in the promotional materials.

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

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* 11. Will attendees need to register or RSVP for your event?

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* 12. Any additional photos, graphics, or artwork?

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

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* 13. Any additional information you would like to add? E.g., speaker biography, event learning objectives, etc.

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* 14. Who should be contacted for more information about the event? 

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