THE FINAL RELAPSE PODCAST INTAKE FORM

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Full Name*

Preferred Name / Pronunciation

Email*

Phone Number (for quick day-of coordination)*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Time Zone*

Short Bio (2-4 sentences)*

Full Bio (up to 300 words – optional)

1–3 Accomplishments You’re Most Proud Of*

Businesses, Brands, or Organizations You're Involved With*

Website / Landing Page (if applicable)

Instagram

Facebook

TikTok

YouTube

Any Other Links to Include in Show Notes

What’s Your Mission in Life Right Now?*

What Core Values Guide Your Life and Decisions?*

What’s Your Stance on Alcohol and Sobriety?*

What Does Masculinity Mean to You in 2025?*

What Type of Leadership Does the World Need More and Less Of?*

Anything Controversial You Believe but Most People Won’t Say Out Loud?*

Story, Transformation, or Moment to Explore on the Show*

Topics That Are Off-Limits or You’d Rather Avoid*

Do you have a reliable camera, mic, and internet connection?*

Yes

Any Questions or Concerns About the Interview?

Why Are You a Good Fit for The Final Relapse?*

Anything to Avoid When Clipping? (Optional)

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