Any UW-Madison student is eligible to use Survivor Services and our Women’s Health Clinic
Outreach request form
Use the form below to request a speaker from UHS. While some details may not be immediately available, we appreciate you making every effort to submit this form at least two weeks before your event. Requests of extremely short notice (within five days of the event) may not be accommodated depending on staff availability.
If you have any questions regarding the form, please contact UHS Communications at firstname.lastname@example.org.