Healthy Okaloosa Speakers Bureau Request Form

Event Information

Thank you for your interest in the Healthy Okaloosa Speakers Bureau! If you are interested in hosting a speaker for an event, please complete this form. Please keep in mind that our speakers usually prefer around three weeks of notice before an event. Someone from the Healthy Okaloosa Team will contact you soon about your request.

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* 1. Please provide your contact information.

Your Name

Name of Workplace or Organization

Phone Number

Address of Event

Potential Date of Event

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* 2. How long would you like the event to last? Please keep in mind that some trainings may be longer than others. Presentations for events like Lunch and Learns can be shortened to fit in the typical 30 minute to 1 hour lunch time frame.

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* 3. What topic would you like the speaker to cover? If your preferred topic is not on this list, please let us know in the comment box. We may be able to accommodate some topics that are not listed below.

Stop the Bleed Training

Recipe for a Healthy Baby

Drug Endangered Children

Helmet Fitting/Bicycle Safety

Poison Prevention

Outdoor Hazards (venomous snakes, spiders, etc.)

Nutrition

Health Promotion

Worksite Wellness

Financial Wellness

Child Passenger Safety

Safe Strides Fall Prevention

Sugar and Internal Health

Making Sense of Nutritionals

Weight Loss

Gaining Control Over Type II Diabetes

Hydration

How to Improve Your Health

Proper Body Mechanics

Lifting Techniques

Tobacco Cessation

Motivational Interviewing for the Healthcare Provider

Effects of Tobacco on the Cardiopulmonary System

Head to Toe: The Health Consequences of Tobacco Use

Other (please specify)

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* 4. Would you like your event to be:

In person

Virtual

A combination of in person and virtual

Pre-recorded

Other (please specify)