Podcast Interviewee Form
My goal for The Chronic Illness Therapist Podcast is to bring accessible information to the general population about how people can manage their chronic and invisible illnesses. You story can resonate with so many people, helping others and yourself feel less alone.
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Email *
Your name (and pronunciation if needed) and age.
Your pronouns? Mine are she/her/hers.
What state are you in?
All the questions on this form are meant to spark ideas, in case you aren't sure what to say. However, maybe you know exactly what you would want to talk about on the podcast already. If so, please provide a synopsis of that here. Only answer the other questions if you feel you want to :)
A short summary of your story. What's your diagnosis? How has that impacted you?
What's a common misconception society has about your illness?
Are there any tips you have for other listeners - something that helps you live your life to the fullest?
What you hope listeners will gain by listening to your story, insights, experience, education, etc. OR what are you dying to talk about in relation to chronic illness?
What is your biggest pet peeve about how people with chronic conditions are treated in this country/world?
where can our listeners connect with you? (email, website, social media, and city/state)
do you have headphones (other than apple earbuds) with a mic for this interview and a quiet place to talk? (preferably in a room with carpet and/or lots of sound-proof objects like blankets, boxes, etc). it's totally fine if this isn't possible!
What days/times are best for you? I ask for 90 minute time slots just in case there are technical or other issues, but the actual podcast should be between 45-60 minutes. If you have a certain time restraint, please let me know below!
Do I have your permission to post audio and written content from this podcast episode to podcast platforms, my social media accounts, my email list, and my website? Your name will always be credited/mentioned.
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If you have anything else you feel is important for me to know before we start, please write that here! Also feel free to ask any questions you might have from me.
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