Schedule a Fit to a T Session

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Please fill in as much information as you can. If you do not have a healthcare professional to present the program USBJI will be happy to locate a presenter for you.

Venue

Preferred date(s) and time(s)

Expected Number of Participants

Session Venue Name

Session *

Live Session

Webinar Session

Videoconference Session

Recorded Session

Street Address

Street Address Line 2

City

Postal Code

State/Province

Organizer

Name Prefix

First Name *

Middle

Last Name *

Name Suffix

Position

Organization Name

Address type

Street Address

Street Address Line 2

City

State/Province

Postal Code

Country

Phone Number *

Phone Extension

Phone Location

Email *

Do you have a healthcare professional to lead the presentation? *

Presenter

Name Prefix

First Name

Middle

Last Name

Name Suffix

Credentials

May include academic credentials (e.g. MD, PhD), certifications (e.g. PMP, CFP), affiliations (AAO SJ), and the like.

Job Title

Organization Name

Presenter Address

Street Address

Street Address Line 2

City

State/Province

Postal Code

Phone Number

Phone Extension

Session

Session Location Name *

Address

Country

Address 1

Address 2

City

State

ZIP code

Organizer Contact Information

Name *

Email *

Phone *

Best number to reach you at.

Address

Country

Address 1

Address 2

City

State

ZIP code

Position

Professional Organization

List the professional organizations you are a member of.

Presenter Contact Information

USBJI will provide a HealthCare Professional to present if you do not have one.

Name

USBJI will provide a HealthCare Professional to present if you do not have one.

Credentials

Phone

Best number to reach you at.

Address

Country

Address 1

Address 2

City

State

ZIP code

Position

Promoting the session(s)

Bookmarks Quantity:

With date, time, place, and speaker details.

The USBJI will send you quantities of the following handout materials based on the expected number of participants.

Booklet/National Resource List/Bibliography A Fit to a T booklet accompanies the presentation and is for distribution to session participants along with a Self Risk Assessment Questionnaire, Resource List, and Bibliography.

The NIH Osteoporosis and Related Bone Diseases - National Resource Center (NRC) will send you copies of the Surgeon General's report on Bone Health and Osteoporosis, a condensed summary for the lay public.

Disclaimer: These books may not have been approved by healthcare professionals and the information they offer should not be used without consulting your own physician.

To request copies of People’s Piece “What It Means to You,” indicate the number next to each respective language below:

English

Spanish

Chinese

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Schedule a Fit to a T Session

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