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Before filling out a Speaker Request Form, make sure you understand the following:

Presentation / Materials / Speaker Request Form

Here at LCP, we work on eliminating suffering and death in Louisiana by focusing on cancers that can be prevented or detected early and cured. These cancers include breast, cervical and HPV-related, colorectal and lung and tobacco-related.

Breast & Cervical

For breast and cervical, we have standard information and presentations on those cancers, as well as information on our Louisiana Breast and Cervical Health Program (LBCHP), which provides no-cost mammograms and Pap tests to women who qualify. Several members of our staff can speak on this topic, which is especially popular in October, so be aware of that demand when making requests at that time.

We can also speak on the topic of breast cancer in young women, as our SurviveDAT project provides online resources and support for those women across the state, as well as across the region as part of the Gulf States Young Breast Cancer Survivor Network.

And, finally, Dr. Donna Williams, the director of LCP, is an expert on HPV and HPV vaccination and can speak on this topic to the media, panels and other expert/provider/parent group gatherings.

Colorectal

We have a large, walk-through inflatable colon, as well as two small colon wall displays to educate people about colorectal cancer, which can be borrowed at no cost for display by health entities (transport costs are responsibility of the borrower). These requests are granted on the understanding that borrowers are responsible for transport, proper display of LCP signage/materials, care and return of all materials to LCP. People should also understand that the large colon generally requires two people to lift and carry.

Colorectal experts on the topic can also be requested as LCP works with several groups throughout the state to raise colorectal cancer screening rates and lower the incidence of this cancer.

Lung & Tobacco-Related

We work with several health entities around the state to provide tobacco education, as well as work to link people to tobacco cessation services. Contact us if you need help finding information or services.

PLEASE NOTE:  Due to a high demand for speakers, completing a form does not guarantee that we will be able to participate. You will receive an e-mail confirmation if we are able to participate.

If you are having technical difficulties submitting this form, please call 1-888-599-1073 for assistance.

Date of Event *
Date of Event
Start Time of Event *
Start Time of Event
End Time of Event *
End Time of Event
Contact Name *
Contact Name
Last, First
Contact Phone *
Contact Phone
Number we can call prior to event for more information
Contact Phone on Event Day *
Contact Phone on Event Day
Number we can call day-of event
Check all presentation items that you need for the event:
Please include any specific information about your organization that you think will be helpful for the LBCHP representative (background of group, purpose of the event, full agenda)