Potential Guests

Interested in Being a Guest on Our Show?

Complete this form to become potential guest on our show. Completion of this form is not a guarantee that you will be selected to be a guest on our show. There are a number of factors that go into the decision selection process and the final decision is at the sole discretion of The Umbrella Hour. If you are selected we will contact you.

First Name *

Last Name *

How do you wish to be introduced on the show *

Cell Number (Not to be published) *

Email (Not to be published) *

Portrait Photo

Upload a portrait of yourself! Please make sure file size is no more than 64MB.

Social Media Sites

Select all applicable social media sites that you would like us to share with our audience and enter in the associated URL below. Include the entire URL with the prefix HTTPS://www.

Website URL

Include the entire URL with the prefix HTTPS://www.

Company or Organization Name

Topic Idea *

Provide 1 topic you would like to talk about as our guest. Maybe you have written a book, made a documentary, are an expert on a specific subject, etc.?

Description of Topic *

Provide a description of topic you would like to talk about. Please limit character count to 160 characters.

Is there anything that you want the host to avoid asking you about during the recording? *

I understand

I understand that during the audio recording I should mute my cell phone and eliminate any distractions.

Can you recommend any potential guests for us to interview? If so, please provide their name(s) and contact information. Thank you.

I agree

I understand audio versions of this episode will be recorded and distributed as broadly as possible on UK Health Radio [UKHR] as well as multiple social media platforms, YouTube, International Podcast platforms, and any other current or future distribution platform. I acknowledge that I will not receive compensation for this recording beyond the publicity I receive. I release UKHR and The Umbrella Hour from any and all claims that may arise from the use of this content as described herein.

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