RCEMLearning Podcast Form

We would love to have you on the RCEMLearning podcast. To make sure you are the correct fit, we have a few questions we start recording.

Initial

E.g. Mrs, Mr, Mx, Dr

Name*

First NameLast Name

Email Address*

Hospital Grade*

this would be your title across all content artwork

Upload your Headshot

Browse Files

this will be used in all content artwork

Are you interested on collaborating in a larger piece of work, after the interview?

YesMaybeNo

How would you like to be introduced on the show? please provide a short paragraph (bio) that we can read for the recording.*

A little bit of background and family history, inspired experiences.

We prefer conversational, non-scripted interview. But we like to focus on specific topics or talking points. What would you like to discuss? Provide bullet points here.*

Do you have any medical resources we can provide in the footnotes? Link them here*

What lesson or message would you like our audience to walk away with?*

Any topics you would prefer to avoid?*

What is one question you wished you were asked more often on medical podcasts?*

Do you have an organisation that you would like me to mention on the episode? *

Yes!None

If yes, what organisation is it?

Would you be open to sharing the episode content with your audience?

Yes, of course!No, thanks

I hereby acknowledge that the RCEMLearning platform are the sole owners of all the rights in an to the Media Program and the Podcaster has the sole right to use, publish and distribute the Media Program and Guest's performance in any and all media formats on all platforms worldwide, as they see fit.

Signature

RCEMLearning Guest Information