When Autumn Comes: Guest Submission Form
Do you have an amazing disabled kiddo and a story or two to share with other moms?   We are looking for medical and special needs moms to be guests on our podcast!  

Basically, it is an excuse to spend an hour away from your kiddos, share your story, bring awareness to our world, but most importantly, help other mamas who may feel alone in their journey.  Plan to spend approximately an hour having a conversation with the two hosts, Susan and Diane, about your life as a medical and/or mom of a disabled child.

Prior to the recording we will converse either via email or phone about what to expect.  We will share the layout and pre-interview show questions/topics to help you prepare.   We also require a pre-interview phone call that usually is done 1-2 weeks in advance and only lasts 10 minutes.

Things to note:
- You do not have to be a public speaking professional to share your story.  Don't stress.
- Just because we record together does not necessarily mean will will use all of your story.  We have the right to edit (usually just shorten to fit our time frame) or to use parts of your story on compilation episodes.
- You will not be able to hear your episode before it is published.  If you have a question or concern, we can absolutely chat prior though.

** At the moment our interview calendar is full.  We will resume interviews mid-summer and will be rolling out new content in the end of August/early September. But fill out the form NOW so that you are top on the list! **

Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Mailing Address *
Cell Phone *
Email Address *
Website (if you have one)
Facebook Page (if you have one and want to share it)
Instagram Handle (if you have one and want to share it)
Tell us a little bit about you and your special needs child(ren)?  Age? Medical Condition? Favorite YouTube Video? Anything you want to share or that we neeeeed to know? *
There is no such thing as typical in our world.  What makes your journey unique?   Do you have a specific part of your special needs journey you want to share with our audience?  (For example, do you want to talk about your NICU journey, living without a diagnosis, special needs parenting when your child is an adult, rare disease parenting, the loss of your child, adopting a special needs child... We can't wait to hear your story!) *
We usually ask guests to have one or two "topics" or "themes" they want to share.  We can pull them out of the information you have given us above or you can tell us what you really want to share.                                              If you have them, what is your preferred Topic or Theme #1 (15-30min): Topic or Theme #2 (as time allows):
Have you ever been on a podcast before?
Clear selection
If you answered yes, please provide a link to your guest episode.  If no, then please put N/A.
I understand that my submission today does not guarantee a spot on the show. I also understand that the producer will follow up with me if interested, so there's no need to send a follow-up email. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy