Video Conference Request Form – FOR ORIGINATORS ONLY!!!


If you wish to be added to an existing video conference DO NOT fill out this form. Send an email instead to to be added to the existing video conference.

After you have chosen the Date, Time, and Site that you would like to request for videoconferencing, you’ll need to put that information on the Video Conference Request Form below. Fill out the form and submit it and we will add your request to the VC schedule.

1. ALL ITEMS MARKED WITH A RED STAR ARE REQUIRED BEFORE THE REQUEST CAN BE SUBMITTED!! Submissions with inaccurate information will not be scheduled.

2. Before submitting this form you should a) check for availability of equipment and b) ensure participants reserve a video conference equipped room in each location.

3. Requests should be submitted at least two weeks in advance. Approved uses include any State of Virginia or Federal business.

4. Requests are approved on a first come, first serve basis. Exceptions included Tele-Medicine and Public Health Preparedness. If the request is external to VDH please provide a technical contact for testing.

5. Before the video conference begins, the site Point of Contact should make sure the equipment is turned on and ready.

6. After the video conference ends, the site point of contact should check the equipment’s condition.

7. Any equipment problems during the video conference should be communicated to the site Point of Contact.

8. Repair and/or replacement of equipment resulting from misuse is the responsibility of the district or office site.

9. For more information contact Richard Watson ( or Brad Bradley (