Pre-Interview Questionnaire - www.thebrainymoms.com

We are excited about your interview on the Brainy Moms podcast! Please take a few minutes to complete this pre-interview questionnaire to help us plan your episode.

Name *

First

Last

Email *

How would you like to be introduced? *

Name with credentials and maybe your profession/job title…not a full bio. We’ll ask for that in a minute! (i.e. Cognitive Psychologist Dr. Amy Moore)

What name would you like us to call you throughout the interview? *

i.e. Dr. Amy, Dr. Moore, Amy, etc?

How do you pronounce your name?

We don’t want to say it incorrectly. So, please help us out with an illustration if your name is any harder than Moore or Smith or Jones. (i.e. rhymes with or the phonetic spelling.)

Please write a 2-3 sentence bio for us to use in crafting your introduction. *

Please give us a list of 3-5 talking points you want to cover during the interview. You can list these as “main ideas” or as specific questions you’d like to answer. We'd love it if you give us some detail here. It truly helps us design an interview tailored just for you! *

Name of your book, podcast, service, or product you'd like to talk about and promote during your interview: (if applicable)

URL of your website:

Your social media handles for tagging you in promotion of your episode:

(FB, IG, LinkedIn, etc.)

If you haven't already sent us your headshot or photo, please upload it now so we can include it in your episode artwork and social media promotion.

Click or drag a file to this area to upload.

Optional: If you'd like to give us your media kit or other promotional materials, here's the spot to upload those!

Click or drag a file to this area to upload.

If you have a digital copy of your book that you would like to upload, here's the place to do it! (You can mail us a hard copy instead, but we prefer paperless!)

Click or drag a file to this area to upload.

If you'd prefer to give us a link to download your book, you can put that in this box!

Permissions *

I agree to have my interview recorded and released as an episode (regular and/or special) of the Brainy Moms podcast.
I understand that audio, video, and written versions of my interview may be published.
I understand that I won’t be paid for my appearance on Brainy Moms.
I give Brainy Moms permission to promote my episode on multiple platforms using quotes, clips and snippets, and cool graphics.
I understand that the Brainy Moms team would appreciate it if I would share my episode with my followers.