Dr. Alex Spinoso | Speaking Request Application

Thanks for your interest in bringing Dr. Alex Spinoso to your stage. Please complete the form below to help us determine if your event is a great fit.

CONTACT INFORMATION

First Name

Last Name

Email *

Phone *

Website *

Brief Business Description (1–3 sentences: who you help, what you do, how you do it) *

SPEAKING FORMAT + TOPIC

Will this event be virtual or in-person? *

In-person (Standard Keynote Fee: $10,000)

Virtual (Keynote Fee: $5,000)

SPEAKING FORMAT + TOPIC

Which keynote are you requesting? *

How to Make More Money in Your Medical Clinic

How to Conquer What You Can Control

Business Is Chess—And Kings Never Win Alone

Custom Keynote ($15,000 minimum speaking fee)

EVENT DETAILS

Date of Speaking Engagement

What time is the event, and what time is Alex expected to arrive/speak? *

Type of Event (conference, private mastermind, podcast, media appearance, etc.) * *

How long will Alex need to be on stage or on camera? * *

If other, please explain:

What are the main talking points or themes you'd like him to touch on? *

Logistics & Agreements (For In-Person Event Only)

Will Alex be featured in event advertising or promotional materials? *

Yes

Link to Event / Podcast / Website *

Social Media Links (Instagram, LinkedIn, YouTube, etc.) *

LOGISTICS & AGREEMENTS (For In-Person Events Only)

Do you agree to cover hotel and flights for Dr. Spinoso and one team member? *

Yes

Logistics & Agreements (For In-Person Event Only)

Will Alex have access to use a PowerPoint presentation on stage? *

Yes

Logistics & Agreements (For In-Person Event Only)

Do you agree to send the raw footage of Alex’s talk or interview after the event? *

Yes

Logistics & Agreements (For In-Person Event Only)

Do you agree to allow Alex’s team to record behind-the-scenes or social content on-site? *

Yes

Logistics & Agreements (For In-Person Event Only)

Do you agree that all uses of Alex’s name, image, or likeness must be approved before publishing? *

Yes

Logistics & Agreements (For In-Person Event Only)

Do you give permission for Alex and his team to use content from the event in future promotional materials? *

Yes

Will there be any other required appearances?

FEE AGREEMENT

Do you understand and agree to the speaking fee structure? *Virtual Keynote: $5,000 In-Person Keynote: $10,000 Custom Keynote: $15,000+ *

Yes, I understand and agree

No, I am unable to proceed at this time

Final Note

We review every application personally. If it feels like a great fit, our team will be in touch to confirm availability and next steps.