2025 CHES®/MCHES® Interview Profile Form

National Commission for Health Education Credentialing, Inc.
CHES®/MCHES® Interview Form
Thank you for your interest in sharing your story as a Certified Health Education Specialist!

Please fill out this form to the best of your ability. You do not need to fill out every question, especially if it does not directly apply to your work or the story you wish to share. If you have any questions about this form, or how to complete it, please email Jess at jwessner@nchec.org.

Note: Upon completion of an interview, a draft article will be shared with you BEFORE your story/interview is published, so that you will have a chance to make edits/changes as you see fit.
Name*

First NameLast Name
Degree(s) and Certifications (eg. MPH, CHES)*
Email*
example@example.com
Certification Type*
YesNoUnsure
Employer*
If you are a consultant or not working currently, please enter "Self"
Job Title (or Volunteer Position Title)*
HealthcareGovernmentSchool or College HealthAcademiaBusiness or Non-profitOther
EmailZoom call
Number of years experience in the health education and promotion, or public health field.
Give a brief synopsis of your normal scope of work.
What event or project are you MOST proud of in the past year or two? (one to two sentences - we can discuss this in-depth in our interview)
YesNo
Please upload a photo of yourself. This can be a profile picture or a photo of you in the workplace or community. The more the merrier!

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If applicable, upload an additional photo of your workplace, colleagues, community members or events, etc. Please not that this photo may be shared on NCHEC's blog page or social media pages, so please make sure you have any approval necessary before sharing photos of colleagues/workplace etc.

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If there are any additional resources you have created, or wish to share, please upload here. We can also discuss them in the interview.

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I acknowledge that my participation in this request is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of this media or participation in NCHEC marketing materials or other NCHEC publications. I acknowledge and agree that publication of said media confers no rights of ownership or royalties whatsoever. NCHEC and licensees or assignees may have unrestricted use of these for whatever purpose, including marketing or advertising, with any retouching or alteration without restriction. I hereby release NCHEC, its contractors, its employees, and any third parties involved in the creation or publication of marketing materials, from all claims and liability relating to this story, images, quotes, video, or photographs provided by me. I understand I will be given final approval of the content and photographs before publication.*

I agree to terms and conditions
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National Commission for Health Education Credentialing, Inc.

CHES®/MCHES® Interview Form