Dragonfly Mental Health Media Request Form

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Hello! Thank you for your interest in having Dragonfly Mental Health contribute to the discussion on mental health in academia on your platform!

Please fill out the pertinent information below so we are aware of the particulars of your request and we will get back to you promptly!

Thank you!

Name *

Email *

What is your position at your company/institution? Who you are representing?

Content Type *

Blog

Podcast

Webinar

Article

Conference

Other:

Scope of the project (i.e. one time contribution, monthly guest spot, etc.) *

Who do you want to contribute? (check all that apply; indicate specifics in the "Additional Information" section) *

Any member of the Dragonfly Executive Team (CEO, COO, Executive Director, Chief Admin Officer, Accessibility Director, etc.)

Any Dragonfly member

A Dragonfly member from an underrepresented group (BIPOC, LGBT+, etc.)

A Dragonfly member who can speak on a specific mental health condition

A Dragonfly member from a specific career stage (PhD Student, Post-Doc, ECR, Faculty, Staff)

Other:

Required

Please check if this is a time-sensitive request

This is a time-sensitive request

Additional Information (optional)

Submit

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This form was created inside of Dragonfly Mental Health.