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SAMHSA Speaker Request Form

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Thank you for contacting the Office of the Assistant Secretary for Mental Health and Substance Use. We appreciate your interest in inviting SAMHSA to participate in your event. All meeting and speaking requests must be submitted through the web form below. We request that you submit this form along with any supporting materials preferably 12-weeks prior to the event date. Please note that all requests will be reviewed before a final determination is made. We cannot guarantee a response any earlier than four weeks before the requested date.

A letter confirming receipt of your request will be emailed to you after submission.

For more questions please direct them to

Speaker Requested
Event Type
Address Type
Proposed Speaking Topic(s)
Event Address
What types of media are invited to the event?

Event Contact

Form Approved OMB# 0990-0379 Exp. Date 8/31/2023

Last Updated

Last Updated: 04/12/2023