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Siksika Health Comms Request Form
January 6, 2025
Siksika Health Comms Request Form
Name & Email Contact
(Required)
Topic/Subject Matter
(Required)
Preferred Communication Type – Check All That Apply
(Required)
Please note: preferred selection(s) is not guaranteed.
Printed Poster, Postcard, or Brochure (plan for costs)
Post on the Siksika Health Website
Siksika Health Online Calendar Post
Event Coverage – Photos, Storytelling (News-like writing)
Online Form
Social Media Post
Written Document
Digital Billboard Sign
Indoor Signage (plan for costs)
Outdoor Signage (plan for costs)
Siksika Health Newsletter Submission
Siksika Media Radio Spot
Business Cards (By Request only; Please contact Team Leader)
Staff ID Cards (By Request only; Please contact Team Leader)
Who is this initiative/piece for?
(Required)
Who/which department is responsible for this initiative?
(Required)
Who is the main contact? Name of person & department area, and contact info.
(Required)
Where is this initiative happening?
(Required)
When is this initiative happening?
MM slash DD slash YYYY
Why is this initiative happening? What is the purpose/intent?
(Required)
Are there any specific/features
First served?
Door prizes?
Is registration required
Sponsors/partners to acknowledge?
Does your initiative involve any IT requirements? AV, PA, etc, If so, please refer to the IT Request Forms
Information to be Communicated
(Required)
Please include as much detail as possible, at minimum: who, what, where, when, why. This will help our team understand context, and communicate accurate information.
Uploading file(s) as part of this comms request? If so, please upload below.
(Required)
Yes
No
File
Max. file size: 128 MB.
Intended Audience (who is this information for?) – Check All That Apply
(Required)
Internal – Siksika Health Staff
External – Siksika Nation Community & Public
Ages 16 and under
Ages 17-29
Ages 30-60
Ages 60+
Scope
(Required)
How large/significant is this request? Is it one-off, or part of a larger campaign? For how long will it need to be communicated?
One Time
Recurring (i.e. weekly events)
Campaign/Event Promotion (ongoing until event date/campaign end date)
Deadline: When Do You Need This By?
(Required)
Please note that comms requests require a minimum 48hrs (2 business days) turnaround allowance. Depending on scope of request, more time may be required.
MM slash DD slash YYYY
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