Southwest Colorado Pediatric Mental Health Symposium - Durango, CO - Speaker Reply Form - With Travel Preferences | Children's Hospital Colorado Continuing Education

Speaker Form

Thank you for serving as a speaker at the Southwest Colorado Pediatric Mental Health Symposium - Durango, CO on September 8 and 9, 2025. Please complete the following form.

Name (first and last) *

Email address *

Cell phone *

Title of presentation(s) *

List one objective per presentation for the brochure *

SPEAKER LISTING FOR BROCHURE (NAME, CREDENTIALS, ACADEMIC TITLE, EMPLOYER, CLINICAL TITLE, EMPLOYER)

Examples

Kay Kinzie, MSN, RN, FNP-BC
Clinical Manager
Immunodeficiency Program
Children’s Hospital Colorado

Adam Rosenberg, MD
Professor of Pediatrics
University of Colorado School of Medicine
Attending Neonatologist
Neonatal ICU and Special Care Clinic
Children’s Hospital Colorado

Provide your speaker listing below *

Speaker bio - create a brief bio introduction *

Who is your employer? *

Children's Hospital Colorado Team Member

CU School of Medicine Provider

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Southwest Colorado Pediatric Mental Health Symposium - Durango, CO - Speaker Reply Form - With Travel Preferences

Speaker Form

SPEAKER LISTING FOR BROCHURE (NAME, CREDENTIALS, ACADEMIC TITLE, EMPLOYER, CLINICAL TITLE, EMPLOYER)

Examples

Kay Kinzie, MSN, RN, FNP-BCClinical ManagerImmunodeficiency ProgramChildren’s Hospital ColoradoAdam Rosenberg, MDProfessor of PediatricsUniversity of Colorado School of MedicineAttending NeonatologistNeonatal ICU and Special Care ClinicChildren’s Hospital Colorado

Kay Kinzie, MSN, RN, FNP-BC
Clinical Manager
Immunodeficiency Program
Children’s Hospital Colorado

Adam Rosenberg, MD
Professor of Pediatrics
University of Colorado School of Medicine
Attending Neonatologist
Neonatal ICU and Special Care Clinic
Children’s Hospital Colorado