ASHHRA Benefits Symposium 2025

ASHHRA Benefits Symposium 2025

Monday, Jan. 27 - Wednesday, Jan. 29, 2025

Thank you for your interest the 2025 ASHHRA Benefits Symposium. Please complete the form below.

IMPORTANT: ASHHRA and its sponsors will make every effort to invite interested applicants, however, space is limited. Submission of this form is an indication of your interest only and not a guarantee of your attendance.

Please indicate if you are interested in attending.*

Select

First Name*

Last Name*

Email*

Work Phone*

Cell Phone*

Title*

Organization*

City*

State*

Biography

Number of Sites

Number of Employees*

Type of Organization*

Select all that apply

Select or enter value

Your Span of Control*

System/Organization, Region/Market, Site/Location, Specialty

What do you hope to gain from attending the event?*

What are the top three issues you are currently facing?*

Dietary Restriction(s)/Preference(s)*

Select or enter value

Other Dietary Restriction(s)

Emergency Contact*

In case of an emergency, please provide the full name, cell phone number and your relation to your contact.

Notes/Comments

Terms and Conditions*

By checking the box below, you agree that your information will be used by ASHHRA to send you event updates and, if selected for attendance, to be included on the attendee roster. It may also be used to deliver information to you about other relevant healthcare events or products and services offered by our corporate partners.

Send me a copy of my responses

Privacy Notice|Report Abuse