Request a Clinician

Thank you for your interest in working with one of our Conn Selmer Educational Clinicians. Please note that this request is not a binding agreement between your organization, Conn Selmer, or any of the clinicians.

To be considered, your event must be scheduled no sooner than 90-days from the date you submit your request. Once your form has been received, a Conn Selmer representative will contact you to clarify your request further and connect you with the requested clinician. Please allow 7-10 business days for our team to process your request. We appreciate your patience.

Requestor's Financial Commitment

If your organization chooses to work with one of our clinicians, please note that a financial contribution will likely be involved. In most cases, this includes covering the agreed-upon honorarium and travel-related expenses such as airfare, lodging, meals, and parking. All financial details are typically arranged directly between your organization and the clinician to ensure a smooth and transparent process.

First Name *

Last Name *

E-mail *

Phone *

Extension

Requested Clinicians (Multiple are allowed.) *

School or Organization *

Event Type *

Event Start Date *

Event City *

Event State *

Additional Event Details *

We are processing your entry. Please stand by.

Form successfully submitted.

Thank you for your submission. A Conn Selmer Division of Education representative will reach out to about your request.