HUG Podcast Network Guest Survey
If you watched the video above, we requested a 150-word bio. Use this form to give us the information we need and we'll write your bio for you.

Please answer the following questions to help us create a script for our program. Please fill out a separate form for each program for which you wish to be a Guest (for example, if you want to be a Guest on both Heart to Heart with Anna and Heart to Heart with Michael, you'll need to fill out a form for each show).
Name: *
Your answer
Email Address: *
Your answer
Home Phone (please include area code and country code if outside the USA):
Your answer
Mobile Phone (please include area code and country code if outside the USA):
Your answer
Facebook Name:
Your answer
Twitter Handle:
Your answer
Skype Name:
Your answer
On which program do you wish to be a Guest? *
Required
Please tell us about your role in the congenital heart defect (CHD) or bereaved community (parent, grandparent, heart warrior, doctor, nurse, etc.) *
Your answer
Please indicate the topic you wish to address (please be specific!) *
Your answer
Please tell us about yourself and why you are an expert on that topic (this should be about 150-word bio and might include the name of your/your child's heart defect, your age, surgeries you've had, etc. for H2HwAnna OR you can tell us about your departed loved one for H2HwMichael): *
Your answer
Is there anything else we need to know?
Your answer
Please check all the equipment you have available: *
Required
Do you have, or are you willing, to put Skype on your computer or smartphone? (This is a free app) *
Tell us about your availability to record the program when you will be in a quiet place - preferably alone (please be specific): *
Your answer
Are you interested in volunteering for Hearts Unite the Globe?
Would you like to be a Patron? You can visit our Patreon page here: http://www.patreon.com/HeartToHeart
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