Guest Intake Form

Guest Intake Form

Get Well with Dr. Shel
Thank you for your interest in appearing on the Get Well with Dr. Shel Podcast. Please fill out this form to the best of your ability.

Upon submission, you will be redirected to schedule your interview, conducted every Thursday. Please make sure to choose your correct time-zone when scheduling. Disregard this if you have scheduled already.

If you have any questions about the podcast, please email Lindsey at blslindsey@gmail.com.
Name*

First NameLast NameSuffix with titles
Topic of Choice*
Your Website
Phone Number (incase we cannot reach each other via Zoom)*

Area CodePhone Number
Your Best E-mail [for Zoom- the link will be sent shortly before the interview]*
example@example.com
Please upload a high definition headshot.*

Browse Files

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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. Include any links to gifts you're willing to give our audience as well.*
Is there anything else you'd like to add, like the contact information to an assistant, or something Dr. Shel should know?
When your episodes goes live, how will you be promoting it?

Social MediaEmail ListBoth
Would you like to be provided a swipe copy of social media posts to promote your appearance?

YESNO
Should be Empty: