About You

Short Bio *

Have you ever experienced or overcome a mental health challenge? (Yes/No) *

How does your story or work relate to mental health, service, or leadership? *

Episode Content

What key topics would you like to discuss when it comes to mental health? *

What’s one story or moment that could inspire our audience? *

Are there any specific struggles or breakthroughs you want to share? *

What do you hope listeners walk away with after hearing your episode? *

Promotion Goals

Are you promoting a book, product, event, or organization? *

Share any links you’d like us to include. *

What’s your call to action for our audience? *

Logistics

Preferred time zone *

Preferred days/times for recording *

Any accommodations needed? *

By submitting this form, I confirm that I consent to being audio and/or video recorded for podcast purposes, give permission for my episode and likeness to be used for promotional purposes, consent to the collection and use of my personal information for scheduling, communication, and podcast administration, and that I am at least 18 years old or have the legal capacity to give this consent.