Text Size: A+| A-| A   |   Text Only Site   |   Accessibility
DCBS Logo
SHIBA Speaker Request
Would your organization like a speaker on Medicare health issues? Fill out the speaker request form below and click the submit button and a SHIBA representative will contact you.

Contact information: 
Your name:  
Organization:
Phone:
County:  
Meeting date(s):  
Time:  
Number of participants:
Minimum participation may be required.
 

Topics (Select all that apply): 
Medicare basics
New to Medicare
Part D prescription plans
Enrollment season options

                  

 
Page updated: October 21, 2009

Click here to go to the Oregon Dept. of Veterans' Affairs outreach contact form

Get Adobe Acrobat ReaderAdobe Reader is required to view PDF files. Click the "Get Adobe Reader" image to get a free download of the reader from Adobe.