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• Name *
  First Last
• Title *
• Email *
• Phone *
  ### - ### - ####
• Organization *
• City *
• State *
• Please provide an overview of your recent speaking engagements (Include all presentations within the past three years, event name, size, and location, and your presentation topic). *
• Identify which category your presentation best aligns. *
  General (breakout session) - These 1-hour sessions will be centered around patient experience. Preferences will be given to healthcare provider orgs with an executive presenter.

  General (main stage) - These 45-min to 1-hour presentations are for our most thought-provoking presentations. Preferences will be given to healthcare provider orgs with an executive presenter.

  Marketing/Consumer track (breakout session) - Geared toward marketing executives who actively use NRC Health's Human Understanding Program - Marketing capabilities.

  Poster Sessions – An opportunity for hospitals and health systems to share patient-experience research, case study results, and other valuable insights.
• Does your presentation include application of a NRC Health solution or product? (This is not required to be selected.) *
  Yes

  No
• Presentation Title *
• Please provide a 1-2 paragraph summary of your presentation. You may also include a short outline. *
• Please list at least three learning objectives. At the completion of this session the learner will be able to: *
• Attach your biography *
• Attach your professional photo (high resolution) *
• Attach any supporting material including your presentation slide deck.