Major Medical Website Videos
Casting Patients in NYC for informational videos on a major medical website.

Please submit if you are affected by the following ailments:
- Psoriatic Arthritis
- Heart Failure
- Type 1 or 2 Diabetes
- Medium to severe Psoriasis Patient - who has experience switching medication.
- Parent with a child age 6-12 who has sensitive skin and/or eczema

Shoot will be up to 2 hours in Manhattan on March 22nd, 23rd, or 24th. Video will be shown on the website. Each participant will be compensated $150 for the shoot.

Name
Your answer
Age
Your answer
Phone
Your answer
E-mail address
Your answer
What city/state do you live in?
Your answer
Occupation
Your answer
What ailment affects you?
Tell us a little bit about how this affects you.
Your answer
How long have you been aware of your diagnosis?
Your answer
How do you treat your ailment?
Your answer
Have you ever switched your treatment? If so, how?
Your answer
Please select all times that you could potentially be available for a 2 hour shoot.
How did you learn of this opportunity?
Your answer
To complete your submission, please e-mail reality@lizlewis.com a recent photo with the subject "Medical - Your Name"
Submit
Never submit passwords through Google Forms.
This form was created inside of Liz Lewis Casting Partners. Report Abuse - Terms of Service - Additional Terms