Heart and Hope Conversations Inquiry

Thank you for your interest in joining a Heart and Hope Conversations. Our series highlights authentic stories, lived experiences, caregiving journeys, clinical or professional insight, and reflections that support individuals navigating chronic illness and grief.

Please complete the brief form below so we can learn more about you and determine whether this conversation is a good fit for the series.

Heart and Hope Conversations Inquiry Form

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Full Name *

you Professional else

Email Address *

Phone Number

Professional Title (if applicable)

e.g., MD, LCSW, RN, NP, PT, Patient Advocate, etc.

Organization/Practice Name (if applicable)

Brief Bio *

(2-3 sentences)

Your Connection to Chronic Illness, Grief, Caregiving, or Related Professional Work *

(Examples: lived experience, clinical experience, caregiver perspective, community leadership, advocacy, etc.)

Conversation Interests *

(Describe what themes or experiences would you feel comfortable discussing during a Heart and Hope Conversation.)

What would you hope to have viewers/listeners take away from your story or perspective? *

Are you available for a 30–40 minute recorded conversation via Zoom? *

• Yes
• No
• Not sure

How would you prefer to be contacted? *

• Email
• Phone call (please be sure to provide phone number above)

Is there anything else you would like to share?

Submit

Once submitted, your inquiry will be reviewed. If your story and perspective align with an upcoming episode theme, someone from our team will reach out to schedule a brief pre-conversation call.