Speaking Request

Thank you for contacting us. If you are a consumer or member of the public with an insurance complaint, question or dispute, please follow this link.

If your request does not relate to an insurance dispute or complaint and you would like to schedule the Commissioner’s participation at an upcoming event, at a meeting or on a teleconference, or as a speaker at an upcoming event, please use the form below. Simply click on the Request Type (Event Invitation, Meeting/Teleconference Request, or Speaking Request) then fill out and submit the requested information.

Due to the large volume of requests, please allow 7-10 business days before following up on the request.

* indicates a required field

Request Type (Value Required)

Event Invitation

Meeting/Teleconference Request

Speaking Request

Name of Organization/Person (Value Required)

Speech Type

First Name (Value Required)

Last Name (Value Required)

Address (Value Required)

Address 2

City (Value Required)

State (Value Required)

ZIP (Value Required)

Email (Value Required)

Phone (Value Required)

Website

Topic/Purpose of Request (Value Required)

Attendees (Name, title, whom they represent)

Issue to be Discussed-include position represented by attendees

Number of Attendees

Program Time (Value Required)

Speaker Time (Value Required)

Length of Speech (minutes) (Value Required)

Who will be introducing the Commissioner?

Are there other Guest Speakers? If so, who speaks before and after the Commissioner? (Value Required)

What will the setup be (theater style, round tables, stage/riser, etc.)? (Value Required)

Will there be a podium with an attached microphone? (Value Required)

Yes

Will there be press or media there? If so, who? (Value Required)

Date (Value Required)

Expected format: MM/DD/YYYY

Time

*Include AM/PM

Date/Time is open for change or contains multiple dates

Event Date Note

If the meeting request is happening at a CDI office, please select which office(s) will work for you.

LA
300 South Spring Street, 14th Floor
Los Angeles, CA 90013

SF
45 Fremont Street, 23rd Floor
San Francisco, CA 94105

Sac
300 Capitol Mall, 17th Floor
Sacramento, CA 95814

Address if meeting is not at a CDI Office location

Address 1 (Value Required)

Address 2

City (Value Required)

State (Value Required)

ZIP (Value Required)

Location is outside of country

Outside Country

If submitting on behalf of Person (First & Last Name)

Affiliation With Group or Person

Meeting Request Information

Each of the proposed participants identified in this meeting request form represent and agree that no information supplied in this form is false or misleading with respect to any material fact. The proposed participants also represent and agree that the information supplied does not contain any misleading statements or omissions of any material fact necessary for the Commissioner or the Department to decide whether to accept or reject this meeting request. Furthermore, each of the proposed meeting participants identified in this meeting request form agree that none of them will discuss, attempt to discuss or otherwise communicate or attempt to communicate with the Commissioner at the requested meeting in connection with any matter or issue pending before the Department’s Administrative Hearing Bureau, the Office of Administrative Hearings, or any other quasi-adjudicative tribunal.

To discuss a quasi-adjudicative matter currently pending with the Department, please direct your meeting request to the office of the General Counsel at (415) 538-4010.

The Commissioner reserves the right to terminate immediately any meeting or communication with any or all of the proposed participants identified in this meeting request form in the event that any of the proposed participants depart materially from the subjects for the proposed meeting or communication set forth in this meeting request form, or if any meeting participant attempts to discuss any pending quasi-adjudicative matters in contravention of the representations of the proposed participants referenced above.

In the absence of an applicable statutory exception, the contents of this form and any materials submitted with this form constitute ‘public records’ within the meaning of Government Code section 6252, subdivision (e) and are subject to public disclosure.

By submitting this meeting request form, each of the proposed participants set forth in this meeting request form agree to comply with each of the conditions contained herein.

Meeting Request

Contact Information

Topic & Attendees

EVENT Invitation

SPEAKING EVENT

Date/Time of Event

Location of Event

SubCDIOffice

SubLocation

Submission Information

MeetingNote

Meeting Request Information

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