Request a Speaker

Do you have questions about College standards? Looking for practice advice? Want to find out more about the role of the College? College speakers will visit your group to discuss a range of topics related to physiotherapy practice in Ontario.

To request a speaker, please complete the form below. Please note this form will time-out after 30 minutes. If you take longer than 30 minutes or have problems entering the "word verification" filed below, simply refresh your page (your entered data will be kept) and re-enter the new word verification code and submit.

* Required

Title

First Name *

Last Name *

Email Address *

Company *

Position *

Work Address *

City *

Province *

Postcode *

Country *

Work Phone Number *

Work Fax Number *

Web Address

Requested date of presentation *

Requested time of presentation *

Duration of requested presentation (in minutes) *

Anticipated audience size *

Location of presentation *

What is the purpose and focus of the presentation? *

Will the College have the opportunity to present other key messages that might be of interest to your audience? *
Yes
No

Are there alternate methods this presentation could be made? i.e. teleconference, videoconference *
No
Teleconference
Videoconference
Other

What audio-visual facilities/equipment are available? i.e. projectors, computer, etc.

Other Comments:

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