Health of Business Podcast Guest Intake Form
Thanks for being a guest on the Health of Business Podcast. This podcast is aimed at physiotherapists and clinic owners in BC and we aim to chat about the realities of clinic ownership - the good and the bad, advocacy, the business of health care, leadership philosophy and any other hot topics in the world of healthcare clinic ownership and the profession. This intake form will help to create some themes and topics for us to riff on. I generally prefer to just riff and let things roll during the conversation, but it is nice to have some general references and areas to chat about and pivot off of. 
Sign in to Google to save your progress. Learn more
Email *
Name *
Name of Clinic/Business/Org
Role
Tell me a bit about your business - history, area of focus, community involvement . Why did you start it? etc.
The 7 main areas of business we chat about on the show are broken into the following themes. While all these areas have plenty of overlap, it is helpful to get an idea of which of these themes your expertise lies in - please select from the following list the areas you are most comfortable talking about:
What are the 3+ biggest successes and wins you have experienced in your role in this business?
What are the 3+ biggest challenges you have faced or are currently facing in your business?
What are 3-5 topics/areas you are passionate about and could speak confidently on on the podcast?
Have you spoken on any other podcasts previously? If so, what were some of the positive aspects of it and what would you do differently?

If you have them, please feel free to provide links to previous recordings. 
If you had a message or goal you wanted to communicate clearly to others clinic owners and practitioners on this show, what would it be?
If you were interviewing yourself on this show, give me three questions (or more) you would like to be asked?
Do you have any intriguing stories or experiences that have led you to where you are that might add some exciting and colourful stories to the interview?
Is there anything else that you would like to have me know about your business, your leadership philosophies or experiences?
I would like to be added to Danielle's mailing list for future opportunities for speaking, learning etc.
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of The Balanced Collective.

Does this form look suspicious? Report