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Prior to submitting an Athletico Event Request Form, please ensure the following guidelines are met:

  • Event is taking place is at least 60 days prior to the requested commitment deadline for a decision to be made from Athletico
  • All form fields are able to be communicated to Athletico

If one or both of these requirements are not met, the form will be rejected prior to evaluation. We appreciate your understanding and participation.

You are in the right place if your event:

  • Allows the clinic to connect within the community to showcase specialty services and generate awareness of Athletico and increase free assessments.
  • Allows for NP tracking efforts to be made through setting up a Secondary Referral Source #, Affiliate, etc.
  • Needs Marketing support.
  • Local Sponsorship Examples: 5ks, local races, sport leagues, partnership with local organizations, etc.
  • Local Event Examples: Expos, booths, fairs, etc.

    ** Your AMDM and MBP will review and follow up on next steps shortly after submission**














    Requester Name:

    VPCO (Required):

    RD:

    Athletico Clinic to Support Opportunity:

    Event City:

    Event State:

    Event Zip Code:

    Type of Event:

    Name of Event/Opportunity (Required):

    Date of Event/Opportunity (Required):

    Commitment Deadline (Required):

    Start Time:

    End Time:

    Length of Event:

    Event Location Name and Address:

    Cost of Opportunity:

    Potential # of Participants:

    Name of Organization:

    Type of Organization:

    Event Website:

    Tax ID #:

    Organization Contact Name:

    Organization Contact Email:

    Type of Opportunity:

    Event/Opportunity Details:

    Tracking for Success:

    Annual Event:

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