Schedule a Radiology Appointment

First & Last Name*

Name of Organization (if applicable)

Phone*

Email

Type of Event*

Date of Event (or best estimate)*

Event Start Time (or best estimate)*

Event End Time (or best estimate)*

Expected Attendance*

Is Catering Needed?*

Yes

No

Is Alcohol/Bar Service Needed?*

Yes

No

Is Decorating Needed?*

Yes

No

Room Size Needed*

Whole

2/3

1/3

Dance Floor Needed?*

Yes

No

Name of Decorator (if applicable)

Technology Needs:

Main Screen (center room only)

Side Screen(s)

Projector(s)

Laptop Hookup

Podium/Microphone

Music

Event Recording (center room only)

IT Staff Present

New Field:

Standard Event (round tables & chairs)

Theater (chairs facing front)

Classroom (tables & chairs facing front)

Fair (tables around the room)

Empty (no tables or chairs)