The Bald Project Interview Application
Welcome to the Bald Project

This project is meant to empower those facing baldness or hair thinning from chemo and radiation, through sharing: first person stories, tips, experiences and information. Whether you chose, wigs, hats, scarves, cold caps or nothing at all (like me), your story should be told.

This project is open to:
- ALL Cancer Types
- Chemotherapy patients
- Patients who used Cold Caps and Scalp Cooling Systems for retain their hair through chemo
- Radiation patients who's hair was effected in any way such as thinning or bald patches in radiated area

As a part of the interview process, I like to conduct a 10-15 minute pre-interview phone call. If you are not free in the next 7-10 days for a phone call, I kindly ask that you please fill out this form when your calendar opens up. The call covers the following:
- The interview expectations and needs
- Next steps
- Set the interview location
- Briefly cover your story so you can tell me any highlights you feel are important


Minors: If you are a currently a minor (under the age of 18), I will need written consent from your parent or legal guardian, prior to a phone call. You're parent or legal guardian will also need to be on the call and present for the interview.

*This project is also open to all races, religions, genders, ages, and sexual orientations
(If I missed any group, just know everyone's story is welcome here)

Email address *
First Name *
Your answer
Last Name *
Your answer
Cell Phone Number - (xxx)xxx-xxxx *
Your answer
Location (City & State -or- City & Country) *
Your answer
What is your time zone? *
Your answer
If you are in the Phoenix, AZ area, what interview platform do you think you'd prefer? *
15 Minute Phone Call - Do you have time in the next 7-10 days for a phone call? (Note: if you are outside the U.S. the phone call will be conducted through Zoom.us, the online meeting room) *
Are you currently an adult or a minor? *
Required
Cancer Type(s) *
Your answer
How old were you, when you were diagnosed? *
Your answer
Hair history - Please provide the calendar year(s) you were treated and lost your hair. *
Your answer
Tell me a little about your hair experience. *
Required
Any other bullet points about your story that want me to know before our call? *
Your answer
Are you a part of any kindness project or non-profit organization? *
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