Call for Presentations

Speak at an Event

The Ohio Council for Home Care & Hospice offers educational programs to help providers streamline operations, build efficiencies, and stay abreast of regulations, current issues, and trends.

Thank you for your interest in presenting. You can use this form to submit proposals for webinars, workshops, and special events, including the annual conference. The deadline to submit education proposals for the 2019 Annual Conference & Tradeshow is January 31, 2019.

If you have any questions, please contact OCHCH at (614) 885-0434 or ryan@ochch.org.

Section 1: Biographical Data

Name*
Credentials/Degrees*
Email
Phone*
Employer*
Title*
Speaking History
Meeting/Conference Name
Sponsoring Organization
Presentation Title
Date
Audience Size
Meeting/Conference Name
Sponsoring Organization
Presentation Title
Date
Audience Size
Meeting/Conference Name
Sponsoring Organization
Presentation Title
Date
Audience Size

Section 2: Program Information

Submission Type (Check all that apply);
- Webinar
- Workshop
- Annual Conference & Tradeshow
- Regional Meeting
- Other
Presentation Information
Presentation Title
Presenter’s Name
Presenter’s Title
Presenter’s Credientals
Additional Presenter’s Name
Additional Presenter’s Title
Additional Presenter’s Credientals
Fee

Conflict of Interest Statement

Having an interest in a commercial interest organization does not prevent a speaker from making a presentation, but the audience must be informed of this relationship prior to the start of the activity and any potential conflict must be resolved. In order to ensure balance, independence, objectivity, and scientific rigor at all programs, the faculty must make full disclosure indicating whether the faculty and/or his/her spouse/family has any relationships with a commercial interest organization whose products and services are pertinent to the content of the educational activity. A commercial interest organization, as defined by ANCC, is an entity producing, marketing, reselling, or distributing healthcare goods or services consumed by or used on patients, or an entity that is owned or controlled by an entity that produces, markets, resells, or distributes healthcare goods or services consumed by on patients. If there is a conflict of interest, we will forward and ask that you abide by terms/conditions for speaking to ensure that your presentation is free of commercial bias, to include the potential need to review your presentation in advance if requested.
Is there an actual, potential or perceived conflict of interest for yourself or spouse/partner?
- Yes
- No
Names of Commercial Companies:
Company Name Relationship
- I agree to prepare a fair and balanced presentation that is objective and scientifically rigorous. The content will be well-balanced, evidence based where possible and unbiased. If I am presenting research funded by a commercial company, the information presented will be based on generally accepted scientific principles and methods, and it will not promote the commercial interest of the funding company.
Topic:
- Billing
- Clinical
- Compliance
- Documentation
- Financial
- Hospice
- Human Resources
- Leadership
- Legal Issues/Risk Management
- Palliative Care
- Private Duty
- Quality Improvement
- Surveys
- Technology
- Other
Targeted Audience:
- Beginner
- Intermediate
- Advanced
Program Abstract:
Learning Objectives (List 3-5 objectives using action-oriented terms.)
Objectives Content Time Frame Presenter
Presentation Length:
- Half Day
- Full Day
- 60 Minutes
- 90 Minutes
- Other
Can we record this presentation?
- Yes
- No
Additional Comments:

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1105 Schrock Road, Suite 120
Columbus, OH 43229
(614) 885-0434

Speak at an Event

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