Dear Presenter,

The University of Utah's Spencer S. Eccles Health Sciences Library and Utah Telehealth Network is requesting you to give permission to record and archive your presentation. Archived presentation will be made available for free by users of the World Wide Web for asynchronous viewing via the Internet. All presentations are to be used for educational purposes only and will be protected under the Creative Commons Copyright philosophy. We look forward to your upcoming presentation and wish to thank you for the time and energy it takes to prepare and present to groups such as this.

Please fill out the brief form below and click the submit button at the bottom of the page. All fields marked with an "*" (asterisk) MUST be filled out.
 

Name*:
   

Brief Biography:
   

Title of Presentation*:
   

Date of Presentation (yyyy-mm-dd)*:     

Presentation Abstract:
   

Suggested Reading and Resources you recommend (if any):
   

Make presentation available for asynchronous viewing*:
Yes, I would like to have my presentation available for asynchronous viewing
      (Click here for preview of agreement form. This form will be available for your signature at the time of your presentation)
No, I am not interested in having my presentation available for asynchronous viewing.

If you answered "No", please proceed to the bottom of the form and select the "Submit Release" button

Please indicate a date when the information in this presentation will need to be reviewed for currency (yyyy-mm-dd):

   

Text from picture below: *
   
   

       

If you have questions about this release, please contact John Bramble.