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Event Request Form

Your Name*
Please select your senior director. (Senior Directors, select your cabinet-level representative.)

Event Overview

Is this an in-person or virtual event?*
Proposed Event Date*

This date is unavailable due to blackout bands. Please contact Emily Feicht (feicht@uw.edu) if you have questions.

Please allow a minimum of 4 weeks to fulfill a virtual event request. Please speak directly to Emily Feicht (feicht@uw.edu) to confirm event feasibility prior to submitting this form.

Please allow a minimum of 6-8 weeks to fulfill an in-person event request. 

In addition, due to physical distancing directives, we are not scheduling in-person events at this time. Please speak directly to Emily Feicht (feicht@uw.edu) to confirm event feasibility prior to submitting this form.

Was this event included in your annual plan?*
As you think about your primary audience, which sentence best describes what they care about most in their engagement with UW Medicine?*
If your event is taking place in the next 6-8 weeks, have you spoken with Emily Feicht?
If your event is taking place within 4 weeks, have you spoken with Emily Feicht?

Event Details

e.g. Lunchtime, Happy Hour, Evening, 4 - 6 p.m., etc.
e.g. Virtual meeting, SLU, UWMC, donor home, etc.
e.g. Zoom, video/recording, house party, lab tour, lunch & learn, reception, dinner, etc.
How many people are you inviting? Who are they? How are you building your event invitation list?
Does your invitation list include patients?*
Proposed Outreach Tactics
Budget Sources

Initial Review

Please note: the data submitted above may be edited as needed during this step.

Do you have comments for the requester?

Leadership Team Review

Please note: the data submitted above may be edited as needed during this step.

Enter one email only.
Enter one email only.

Assign to Events Team Member

Please note: the data submitted above may be edited as needed during this step.

Enter one email only.
Enter one email only.

Status Update

Please note: the data submitted above may be edited as needed during this step.