Practice What You Teach Interest Form
Welcome! Practice What You Teach is a YouTube show where helpers and healers share the skills, strategies, or techniques that they use in their own lives. We dig in to what the tool is, how it's used, and how it works for them even when things get busy! As a mental health therapist I have my personal go-to coping skills that I use regularly, and I always wondered what my yoga teacher or dietitian friend's personal go-to techniques or habits were too.

There are 16 episodes out now with a variety of guests, including mental health therapists, couple's counselors, yoga teachers, a health coach, dietitian, crystal healer, reiki master, and a substance abuse counselor. All have shared some really helpful and tangible tips they use, which can help things feel more relatable to viewers unfamiliar with their practices or professions. New episodes come out twice a month.

Please complete this form to be considered for an episode of Practice What You Teach on YouTube. Thank you for your interest! 
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Email *
Name: *
Pronouns:
What type of helper/healer are you? *
Please briefly describe your title and license/certification if applicable (e.g. mental health therapist, dietitian, physical therapist, health coach, personal trainer, reiki practitioner, yoga teacher, etc.).
How do you help/heal? *
Please summarize your business, including what services you offer and any specialities.
What is your personal go-to skill, strategy, or technique that you teach your clients that you also utilize yourself? *
This would be the focus of an episode if we agreed to record! Curious what it looks like? Check out the Practice What You Teach YouTube channel here!
How are your services offered?
Are you virtual, in-person, or hybrid? Do you have any geographic limits on who you can work with? Do you offer 1-on-1, groups, classes/workshops, memberships, etc.
Business Website:
Business Social Media:
Please include links to different accounts
Release for Guests *
By TYPING YOUR NAME below you hereby irrevocably consent to the recording and distribution of reproduction(s) of the Guest's voice and performance as part of the media program/YouTube Channel/Podcast entitled Practice What You Teach (herein referred to as the "Program").

    In consideration of being invited to appear on the Program, Guest does hereby acknowledge that Kimberleigh Hagar (herein referred to as the“Interviewer”) is the sole owner of all rights in and to the Program, and the recording(s) thereof, as “works made for hire” pursuant to 17 USC §101, et.seq., for all purposes; and that Interviewer has the unfettered right, among other things, to use, exploit and distribute the Program, and Guest’s performance as embodied therein in any and all media or formats, throughout the world, in perpetuity.  Any materials created in connection with  the production and distribution of the Program (“Materials”) become property of Interviewer, and Interviewer shall have the sole and exclusive right to use, exploit and distribute such Materials, throughout the world, in perpetuity.

    Nothing contained in this Guest Release shall be construed to obligate Interviewer to use or exploit any of the rights granted or acquired by Interviewer, or to make, sell, license, distribute or otherwise exploit the Program or Materials whatsoever.

    Guest understands and agrees that he/she shall receive no monetary compensation for appearances on and participation in the Program.

    Guest's name and likeness may be used in advertising and promotional material for the Program, but not as an endorsement of any product or service.

    Guest hereby releases and discharges Interviewer from any and all liability arising out of or in connection with the making, producing, reproducing, processing, exhibiting, distributing, publishing, and transmitting by any means or otherwise using the above-mentioned production.

Any questions for Kimberleigh or additional things you'd like to share?

Thank you for your interest in Practice What You Teach!

I'm excited to connect with you and will reach out once your application has been reviewed.
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