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Podcast Guest Form

Thank you! I'm looking forward to interviewing you.

1.Please provide the following contact information.(Required.)
2.Job Title (Most concise way to represent your qualifications and/or role)(Required.)
3.Social media accounts
4.Your brief bio (100 words or less). I will use this to introduce you.(Required.)
5.Upload your hi-res headshot.(Required.)
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6.Please provide a title suggestion for this episode.
7.What THREE takeaways do you want parents to get from this episode?(Required.)
8.Do you have any special offering (e.g. discount) or content (e.g. PDF) you would like to provide that would be useful to parents with teens? If yes, please provide details and link if relevant.
9.I understand that by participating in the Parenting Teens with Dr. Cam podcast interview I grant Dr. Cam Consulting, LLC a non-exclusive, worldwide, royalty-free license to record, edit, reproduce, distribute, and publicly display the interview for the podcast and its promotion (including podcast feeds, episode pages, social media, short clips/reels, trailers, and email newsletters). Any use of the produced media beyond podcast distribution and promotion (for example, inclusion in books, conference talks, standalone commercial products, or third-party licensing) will require my prior written consent and will include clear attribution to me (for example: “[Guest Name], [Role/Title] — originally interviewed on Parenting Teens with Dr. Cam, Episode [#]”).(Required.)