Please fill in all fields below to request space for an event at the Center for Connected Medicine (CCM). The CCM team will review all event requests and respond by email.
First Name *
Last Name *
Company/Department *
Email *
Title of Event or Meeting *
Name of UPMC Executive Sponsor *
Date of Event *
Is this date flexible? * YesNo
Is food/beverage needed for this event? * YesNo
Start Time * 8 AM9 AM10 AM11 AM12 Noon1 PM2 PM3 PM4 PM5 PMOther (please list in description)
End Time * 8 AM9 AM10 AM11 AM12 Noon1 PM2 PM3 PM4 PM5 PMOther (please list in description)
Estimated Attendance (Number only) *
Briefly describe your event: *
Comments
