Submission Form for "The Poisoning of America" Documentary
This documentary aims to challenge conventional views on obesity and unhealthy living, providing an in-depth analysis of the societal factors contributing to these issues. By sharing your story, you can help shed light on the harm caused by misleading products and programs in the health and wellness industry.
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Email *
Name *
Tell us your story: (Please include details about the product or program you tried, the promises made, your experience with it, and any negative outcomes or effects.)
Short Bio: (Tell us a bit about yourself, your background, and why you're passionate about sharing your story for "The Poisoning of America.")
Video Link: Please post a link to your video from any file sharing service like Dropbox, Drive, YouTube, Vimeo, etc.
Consent: By submitting this form, I authorize the use of my story and video for the documentary "The Poisoning of America" and understand that it may be used in promotional materials for the documentary.
A copy of your responses will be emailed to the address you provided.
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