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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:

  • Requires Work Comp CEUs for attendees.
  • Falls into one of these examples: Webinar, Dinner with a Doc, Lunch and Learn, Breakfast Seminar














Requester Name:

VPCO (Required):

Event City:

Event State:

Type of Event:

Name of Event/Opportunity (Required):

Date of Event/Opportunity (Required):

Commitment Deadline (Required):

Start Time:

End Time:

Cost of Opportunity:

Cost Allocation:

Estimated # of Attendees:

Type of CEU Event:

CEU Topic:

CEUs Needed:

Event Location Name and Address:

Venue Requires Contract:

Venue Requires Deposit:

Primary Speaker Name:

Primary Speaker's Practice Name:

Secondary Speaker Name:

Secondary Speaker's Practice Name:

Digital Invite Needed:

Need Eventbrite Registration Page:

Need Campaign Eblast:

Campaign Send Date:

Campaign Details:

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