Material & Speaker Request - O'Neal Comprehensive Cancer Center

The O’Neal Comprehensive Cancer Center’s Office of Community Outreach is a leader in its work educating the public on cancer awareness and the important role cancer screening plays in early detection. The outreach team is happy to provide educational materials or a speaker from the team for events related to Cancer Center initiatives.

Please complete the Educational Materials Request Form or the Speakers/Community Outreach Event Request Form to work with the Community Outreach Office.

Contact Tara Bowman at (205) 975-2643 or tbowman@uab.edu with any questions.

Contact Information

Requesting organization/group(*)

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First name(*)

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Last name(*)

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Email address(*)

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Phone number(*)

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What is your preferred method of contact?(*)

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Request Type

(*)

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Please describe your request

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Do you also need educational materials for this event?(*)

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Educational Materials Request Details

Who is your target audience?(*)

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Please list the materials you are requesting:(*)

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Mailing address(*)

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How many people do you expect to reach?(*)

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Will these materials need to be in any language other than English?(*)

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What language?(*)

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Are these materials being used at an event?(*)

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Event Details

Name of Event or Health Fair(*)

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Date/time event begins(*)

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Date/time event ends(*)

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Event check-in time(*)

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Location of the event/health fair(*)

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Physical address(*)

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Specific population

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Age range of participants

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Bilingual requirements(*)

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If "Yes," what language does the audience speak?(*)

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Please check the equipment items below that will be provided by the requesting organization:(*)

Event dress code

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What are the goals of the event?

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What else should we know about this event?

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(*)

I understand that if my request is not submitted four (4) weeks prior to my event, a volunteer/speaker may not be available to attend. Educational materials may be provided on a shorter notice if approved. Invalid Input

Materials & Speaker Request

Contact Information

Request Type

Educational Materials Request Details

Event Details