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Guided Path Fireside Chat Guest Information Form

Thank you for agreeing to join us on the Guided Path’s Fireside Chat podcast. Please complete this form to help us prepare for your episode and highlight your unique story and expertise.

Guest Information

Birthday

About You

Title or Role (check all that apply):

Fireside Chat Details

Media Consent and Privacy Preferences

May we record and publish your episode across all Guided Path platforms (e.g., website, social media, podcast directories)?
Yes
No
How do you prefer to be identified in the episode?
Full Name
First Name Only
Anonymous

Thank you for sharing your story and expertise with our Fireside Chat audience! Together, we’re creating a meaningful dialogue about advanced-stage and rare cancers.

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