Center for Health and Wellness Promotion

Presentation Request

The Center for Health & Wellness Promotion organizes educational outreach, promotion, and training efforts to increase the well-being of the campus community. These services are available by completing the Student Wellness Presentation Request.

Personal Information (for individual currently completing the form)
First Name:
Last Name:
Department or Organization:
Phone Number:
E-mail:
Presentation Information
Date of Presentation:
Start Time:
End Time:
Department, Organization, or Target Audience
Duration of the Presentation:
Number of Students/Participants expected:
Location of Presentation:
Topic(s) Requested:
If Other, please specify:
Goals of the workshop and/or outreach:

Special requests/specific reason for this request:

Has the presentation been requested before:	Yes No
If Yes, when:
Wellness Boards
I would like to request a copy of the following Wellness Boards (check all that apply):	Adderall Alcohol+Energy Drinks Alcohol Facts Alcohol Poisoning Healthy Relationships Nutrition Sleep Stress Management
Date you would like to pick up the Boards (please allow 48 hours for your boards to be printed): (mm/dd/yyyy)

Please click Submit only once.

Contact Information

Phone (619) 260-4618
Fax (619) 849-8121
chwp@sandiego.edu

Office Hours:
Monday - Friday 8:30 a.m.-5:00 p.m.

University of San Diego
University Center 161
5998 Alcalá Park
San Diego, CA 92110

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