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BCBSTX Event Attendance Request Form

Are you planning an event?

  • Wellness or Benefits Fair
  • Lunch and Learn
  • Conference
  • Wellness or Benefits Presentation

You can submit a request for a BCBSTX representative to attend your event.

Please submit this form at least six weeks prior to your event to allow enough time to fulfill your request.If your event is in less than six weeks, we will do our best to accommodate your request.

Once the form is submitted, please allow up to 72 hours for a BCBSTX representative to respond via email or phone. If you have any changes prior to your event after submitting the request form, you can contact us using the Agency Rep Contact Form with your contact information and the change to the event.

An asterisk (*) indicates a required field.

Requestor Information

Preferred contact method:*

Event Information if Available

Would you like BCBSTX to provide a door prize at your event?*

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A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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