Marketing & Education Request Form

Thank you for your interest in marketing Hanger Clinic in your area. Please fill out the form below using as much detail as possible, and a member of the Marketing & Professional Education Team will reach out within 24-48 hours to confirm details and timing.

Name *

Email *

Phone *

Title *

Region or Department *

PCC / Cost Center *

Today's Date * +

Request Type *

Have you visited HangerOneSource.com and can't find what you need?

Please fill out this form to submit a custom request giveaways/swag/apparel and more.

Tier Level Request (See Tier Descriptions Here) *

I have budget to support custom course application fees. * 🛈

Yes

No

Your Role *

RSM Approval (BDMs Only)
* 🛈

Which program or strategy does your course align with? *

Status *

Speakers Identified *

My education event will: *

Help increase how many patients we serve

Help me build relationship and educate new health system to improve patient care

Help me educate a current customer / health system

Improve patient outcomes

Date of Event * +

Event Start Time *

Event End Time *

Event Location (City, State) *

Event Venue (Location Name & Address) *

Do you have event sponsors? *

Who are the sponsors? *

Attach sponsor logos, if available.

Provide as many additional details as you can about your request. *

Select the Option that Best Describes Your Request *

Project Title *

Project Description *

Relevant Audiences *

Internal

External

Has the video proposal been approved by Internal Comms team? *

Important Note: Internal Communications Approval Required

Please contact Steve DeLeon at stdeleon@hanger.com prior to proceeding with your video request.

Internal Comms Project Approver Name *

Will you need help creating a video script? *

Requested Completion Date * +

What is your budget for this project? Please be aware that videos average $2K-$5K per finished minute. *

How do you plan to distribute the video? *

YouTube

Vimeo

OneHanger

Attach Internal Communications Plan.

Approver Name & Title (Director or Above) *

Number of Copies Requested (One per Clinic Location) *

Mailing Address *

Check the box below to acknowledge that approximately $25 per clinic location will be charged to the PCC / Cost Center indicated above to cover the costs of the USBs plus shipping. *

I acknowledge and approve the costs associated with this request.

Approver Name & Title (ACM or Above) *

Audience *

Referral Sources

Patients

Hospitals

Other: Other:

Topic *

Provide as many details as you can about your request. *

Upload any reference files you may have.

Delivery *

Print Locally

Print Through Hanger Vendor

Digital File

Deadline (Expect a 2-week turnaround on updates to existing assets; more custom items may take longer.) * +

Approver Name & Title (RSM or Above) *

Questions / Contact

You will receive an email response from a member of the Marketing Team within 24-48 hours. If you do not hear from us, or if you have questions or information related to this request, please reach out to marketing@hanger.com.

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