Podcast Guest Info Sheet

If you're interested in being a guest on the AlzAuthors podcast, please complete this form.

Note: Podcast guests must be established as contributors to AlzAuthors with a featured resource - book, blog, podcast, film - in our bookstore or website to be considered as a potential podcast guest. For more info on joining AlzAuthors, visit https://alzauthors.forms-db.com/view.php?id=12338
I am a contributor to AlzAuthors.

I am a contributor to AlzAuthors. Yes No
Guidelines
The podcast is only open to AlzAuthors contributors, which means they already have a resource in our collection. If you would like your work to be considered for AlzAuthors please complete our submission request form: https://alzauthors.forms-db.com/view.php?id=12338 We look forward to reviewing your work!
Your Name
Your Email Address
Your Location (city/state/country)
Your Blog and/or Website:
Please list the URLs for your social media platforms:
Type of resource:

Type of resource: Book Blog Podcast Film Other Other
Name of Resource
Link to Resource
Which category best describes your resource? (please pick only one)

Which category best describes your resource? (please pick only one) MEMOIR: CARING FOR MOTHER WITH ALZHEIMER'S DISEASE MEMOIR: CARING FOR MOTHER WITH EARLY ONSET & OTHER DEMENTIAS MEMOIR: CARING FOR FATHER WITH ALL DEMENTIAS MEMOIR: CARING FOR BOTH PARENTS OR GRANDPARENTS WITH ALL DEMENTIAS MEMOIR: CARING FOR A SPOUSE OR PARTNER WITH ALZHEIMER'S DISEASE MEMOIR: CARING FOR A SPOUSE OR PARTNER WITH EARLY ONSET/OTHER DEMENTIAS MEMOIR: LIVING WITH DEMENTIA CAREGIVER GUIDES FOR ALL DEMENTIAS ACROSS ALL STAGES CAREGIVER GUIDES FOR ALL DEMENTIAS WITHIN LATER STAGES CAREGIVER GUIDES FOR ALZHEIMER'S DISEASE CAREGIVER GUIDES TO INSPIRE THE CAREGIVER CAREGIVER ACTIVITY BOOKS FICTION: CARING FOR FAMILY WITH ALZHEIMER'S DISEASE FICTION: CARING FOR FAMILY WITH EARLY ONSET/OTHER DEMENTIAS FICTION: LIVING WITH DEMENTIA FICTION: BOOKS FOR KIDS FICTION: BOOKS FOR TEENS OTHER GENRES: ANTHOLOGIES & SHORT STORIES OTHER GENRES: ART, PHOTOGRAPHY & POETRY SOMETHING ELSE, PLEASE EXPLAIN BELOW OTHER OTHER
Which type of dementia(s) does your resource mainly address:

Which type of dementia(s) does your resource mainly address: Unspecified/General Alzheimer's Fronto Temporal Degeneration/Pick's Disease Huntington's Lewy Body Disease Mild Cognitive Impairment (MCI) Parkinson's Vascular Something else; Please explain below Other Other
Please include a short bio
Any additional information you'd like to share:
Consent: I understand that should I appear as a guest on the AlzAuthors podcast the audio files and images related to my interview (i.e author photo, book cover, blog banner, etc.), description of my resource, and my bio will be used by AlzAuthors to promote the podcast on their media platforms, including their website, blog, newsletters, and social media. I understand that inclusion in AlzAuthors is for promotional and discoverability purposes only and that sales are not guaranteed. I further understand that if sales are a result of AlzAuthors promotional efforts on my behalf that AlzAuthors may receive a small commission as an Amazon Associate at no expense to myself, and that any monies earned will be used to benefit the work of AlzAuthors. Please indicate your agreement by typing your initials below. Thank you.