Form
Content Collaborator Screener
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Please provide links to your active social media profiles
Educational Background
List your degrees, certifications, and any specialized training in mental, physical, or spiritual health
Professional Credentials
Are you licensed or certified in any health-related field? (Please specify details.)
Have you ever had any of your professional licenses or certifications revoked, suspended, or subject to disciplinary action? If yes, please provide details in the space provided at the end of this form.
Yes
No
What is your primary area of focus?
Mental Health
Physical Health
Fitness/Nutrition
Spirituality
Education
Other (if other please elaborate in the field provided at the end of this form)
What types of content are you most comfortable creating?
Short form video content
Long form video content
Podcasts
Written resources
Other (if other please elaborate in the field provided at the end of this form)
What topics are you interested in contributing to our platform?
14. What is your target audience? Who do you aim to reach with your content?
Are you interested in filming your own content and submitting for review, or filming with our videography team?
Film my own
Film with our team
I'm not sure
Are you open to co-creating or participating in discussions with other experts on Counsel Club?
Yes
No
Maybe
Are you interested in serving in a content reviewer role for future applicants to our platform?
Yes
No
Maybe
How do you currently ensure that your content remains accurate, ethical, and respectful of diverse perspectives in wellness?
Please use this space to elaborate on any responses or to provide any additional details.
Submit
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