Podcast/Radio Guest & Speaker Request Form
Dr. Thompson is a best-selling author and sought after guest. Submit your request here and expect a response in 3-5 business days. Questions? email info@doctormoniquethompson.com
Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Organization Website
*
Job Title Of Primary Contact
*
Please share additional information about the convening organization (e.g. sector, mission/purpose, etc.)
*
Topic and Event Information
Type of Event
*
For example: Live, Recording, Virtual, In-Person, Conference, Panel
Topic of the presentation
*
For example: Relationships, Mental Health, Education, Faith-Based, Parenting, Couples
Expertise Requested
*
Examples: General Mental Health, Infidelity, Zero Debt College Project, Faith Based Mental Health, Workplace Wellness, Couples, Youth, Family, Generational Trauma
Confirm Type of Event
*
Virtual
In-Person
Hybrid
Event Format (select all that apply)
*
Panel Discussion
Keynote Speaker
Formal Presentation
Closed-Door Briefing
Roundtable Discussion
Q & A
Retreat
Other
Please share additional details about the format.
*
Date and time of the event
*
-
Month
-
Day
Year
Date
Duration of the presentation and the event
*
For example, is Dr. Thompson needed for the full event, for a workshop of two hours, to give a keynote, or to be present for a specific portion
If you have additional details about the event moderator and additional participants, please share them.
*
For example, will participants be "LIVE" meaning virtual face-to-face with Dr. Thompson or will they be in a webinar format, or in an audience.
Event audiences (select all that apply)
*
Academics
Journalists
Policymakers
Public
Students
Topic Experts
Other
Please provide more details
*
Do you expect members of the media to attend the event?
*
Yes
No
Unsure
By when will you need a response?
*
-
Month
-
Day
Year
Date
Will an honorarium be offered? (Please note: There are no pro-bono in-person events, select pro-bono virtual opportunities will be considered in 2026, there are no pro-bono virtual or in-person opportunities available for 2025). Non-profits are encouraged to seek a corporate sponsor or donations to cover their honorarium.
*
yes
no
Share anything else that might help with considering your request.
*
For instance, has Dr. Thompson worked with your organization in the past, do you have a pre-existing professional or personal relationship with Dr. Thompson, is there anything else we should know to consider your request?
Submit
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