Seminar Request Form

Fill out the following form by selecting the services you would like to receive, followed by the required information marked with an asterisk *. When finished, simply press the "Submit" button and the information you entered will be automatically transferred to UI Wellness.

If you have any special requests or questions, please enter them here.

Contact Person Responsibilities

The contact person will be contacted by a member of the UI Wellness team to coordinate the details of the requested service. The contact person is responsible to:

  • Disseminate information to colleagues and staff regarding the service.
  • Identify appropriate on-site facilities for the service
  • Provide a class roster list and coordinate distribution of program evaluations.

Supervisor Approval

Supervisor approval is required to provide the requested service. By completing the fields below, you certify that you have supervisor approval for this request.