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By what name would you like to be referred on the podcast? (If you want to stay relatively anonymous, we recommend you use your first name or a nick name, occupation and state. i.e.. David, a surgeon in Florida)
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If yes, please provide the name of your place of employment/business name along with your social media handles or best means of contact.
Please provide a 1-2 sentence bio that Dr. JB will read as your introduction to the Hope4Med podcast.
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In addition to audio, do you want your podcast to be video recorded?
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How many episodes have you listened to?
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What topic would you like to discuss on the Hope4Med podcast?
Burnout
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Please list up to 5 questions or concerns you would like to address during this podcast feature. Please ensure that your responses are evidenced-based.
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As a thank you, we would like to send you a Doctor JB merchandise from our gratitude collection. Please provide us with your mailing address: street, city, state and zip
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