Request a Program

  • Please read prior to completing this form:
    • Request Deadline: Program requests should be made 10 business days prior to the suggested date and time of the requested program.
    • Returning the Form: PRFs can be returned via email to
    • Confirmation: Programs are not considered confirmed until the requesting party receives a confirmation email.
    • The 5/15 Rule: Presenters will wait no more than 15 minutes for at least five participants to arrive before canceling the program.
    Step One: Your Information
  • Step Two: Select the Program or Request a Table

    Please note: You may request Student Health Promotion to facilitate a program in collaboration with your department or organization or you may request our presence at your event. A list of our current program is available on our website.
  • Please provide additional information if you are requesting a Student Health Promotion table at your event or if you require a program designed for your group’s specific needs.
  • Step Three: Select Your Dates

    At least one alternative date and time must be provided for the program.

    First Choice:
  • Second Choice:
  • Step Four: Location