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State of Tennessee Training Request Form

Welcome to the Customer Training Department's Training Order Form

If you have any issues or questions regarding how to complete this form please email the Customer Training Department at customertraining@optum.com or call 1-866-876-2785 ext. 0.
Whenever possible, we ask that trainings are requested 30 days in advance, however the Customer Training Department is able to accommodate more urgent requests as needed.
Additional sessions for the same training topic and site location may be submitted on one form. Please submit a separate training order form, if the topic or site location is different.
Minimum of 10 participants recommended per training.
Fields with a red bar are required.

Company Name	State of Tennessee
*Requester Name
*Requester Phone
Ext
*Requester Email
Additional Emails for Notifications
Are Company Contact & Requester the Same

Authorization Required for Account

Using bank of hours

Event Type

Are you requesting a Custom Topic or a Catalog Topic for this training?

*Training Date

Start Time

End Time

*Timezone

*Number of Participants Expected

Comments or Special Instructions

Is your training date flexible?

Will there be additional sessions required for this training topic?

This form has been completed and submitted by
Same as Requester
*Name		*Email