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)
Cell Phone Number - (xxx)xxx-xxxx
Location (City & State -or- City & Country)
What is your time zone?
If you are in the Phoenix, AZ area, what interview platform do you think you'd prefer?
Undecided - I'd like to wait until our phone call to decide
Question Not Applicable to me
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?
I am over 18 years of age
I am a minor under 18 years & will provide my parent/legal guardian's info in SECTION 2 of this form
How old were you, when you were diagnosed?
Hair history - Please provide the calendar year(s) you were treated and lost your hair.
Tell me a little about your hair experience.
I lost my hair to chemo
My hair was effected by radiation
I used a cold cap during treatment
I donated my hair before treatment
This effected my relationships (either positively or negatively)
I had a hard time coping with baldness and hairless
I had not problems being bald
I've lost my hair multiple times during my cancer experience
I was minor under 18 when I had cancer
Any other bullet points about your story that you want me to know before our call?
Are there any resources you'd like to share that helped during this time? (This can be a variety of things such as: doctors, hair/skin products, books, websites, etc)
Are you a part of any kindness project or non-profit organization?
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