Podcast Guest Form
Suffix with titles
Phone Number (incase we cannot reach each other via Zoom)
Your Best E-mail [Zoom contact information provided via Calendly]
Your Most recent Bio (200 words approx)
Please provide 3-6 SPECIFIC questions that you would like me to ask you during the interview
What program/course/service would you like us to promote on the interview? Also, if you have an affiliate program. Please specify your affiliate program with a link for us to sign up.
Please provide a high-resolution headshot to utilize in the podcast promotional materials
When your episodes goes live, how will you be promoting it?
Recording Rights: By participating in this interview, you agree to allow Shelena Lalji, MD, to record, distribute, and disseminate the interview in any manner. You also agree to allow Shelena Lalji, MD, to retain rights to the produced media for monetization or future use in speeches, books, and in all other public distribution. Type YES to agree
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