CAMC Institute Studio Services Request

CAMC INSTITUTE FOR ACADEMIC MEDICINE STUDIO SERVICES

CAMC Institute Studio Services Request

Please type or print clearly

Department

Contact

Purpose

Continuing EducationOther

Purpose of video production (if not for continuing education)

Project Start Date

We must receive request at least 90 calendar days in advance, late requests will not be considered

Project Deadline

Deadline must be at least 6 to 8 weeks following last day of filming for editing and post-production

Concept

If podcast, complete podcast form instead

Audience

Title of Session

Brief description of video

Studio Time Requirements

Please indicate dates and times for studio sessions. Studio is available between 9AM and 3PM, M-F. Sessions should be no longer than 2 hours.

Studio Session Dates and Times

Objectives for CE Session

By the end of this session, participants will be able to:

True / False Questions for Post Test (for archived CE / enduring material)

CAMC Institute for Academic Medicine will refer you to a 3rd party to hire actors if they are needed for your project. You may choose to have CAMC Employees appear in your project. Please have them complete the attached Biographical Data Form.

Actors or Guest Appearance(s): Biographical Data Form

Note: Please complete this form for each person who will appear in video

Speaker's Name

Credentials

Address

Phone

Fax

Cell Phone

E-mail

Education (including basic preparation through highest degree held):

Degree

Year

Institution

Institution City and State

The following information may appear in the video and other materials, and be used for introductions.

Current Position

Provide a one paragraph description of your professional experience or areas of expertise (including publications) related to the topic of your presentation