Home > Pages > Online Form

AultSpeak Request Form

* Indicates a Required Field

Please complete the below form to request a speaker from Aultman Hospital.

Name of Organization, School, etc*
Contact Name*
Contact Phone Number*
Contact E-mail Address*
Date(s) Requested*
Time of Presentation (please include desired length)*
Address of Presentation Location (include city and zip code)*
Approximately Number of Attendees*
Topics Requested (see options below)
Type of Audience*
Is the presentation part of or in conjunction with another event?*



Topics Available

Wellness and Prevention
Diabetic Diet
Heart-Healthy Eating
Home Safety/Fall Prevention
Relaxation Techniques
Smoking Cessation
Weight Management

Women's Health
Breast Health
Hormone Replacement Therapy
Menopause
Osteoporosis
PMS
Urinary Incontinence
Women and Heart Disease

Heart
Heart Attack - Time is Muscle

Cancer
Breast Cancer
Genetic Testing
Gynecologic Cancer
Lung Cancer
Prostate Cancer

General Health
Asthma
Brand-Name Versus Generic Medications
Cholesterol
Dementia
Diabetes
Dizziness
Glaucoma
Hospice and Palliative Care
Immunization
Infectious Diseases
Irritable Bowel Syndrome (IBS)
Sleep Disorders
Sports Injuries
Stroke Warning Signs

Hot Health Care Topics
Health Care Reform
Health Care Market Trends
What's New at Aultman
Careers in Nursing
  • Consumer Choice Award Winner
  • Emergency and Trauma
  • Vascular Disease
  • Diabetes Education
  • Weight Management
  • Therapy Services
  • CHNA Report 2013
  • Tobacco Cessation
  • LTACH CHNA Report 2013
Open Links
Call a Patient: 330.452.9911
Copyright © 2014
Aultman Health Foundation.  All Rights Reserved.   Site Map  |  Privacy Policy  |  Contact Us | Employees

2600 Sixth St. S.W. in Canton, OH 44710  |  1-330-452-9911  |  Locations & Phone Directory