Personal Information

First name

Last name

Phone

Professional Title

Specialty

Social Media Profile (e.g. Instagram, X, Facebook, Tiktok, or LinkedIn)

Website

Professional Background

Degrees, credentials and certifications.

A brief summary of your professional experience, including current and past roles, and key responsibilities

List any relevant honorary mentions, awards, published work or accomplishments.

Media Experience

Have you received formal media trained? If so, when and where?

Provide details of previous media appearances, including TV shows, radio interviews, podcasts, articles, or public speaking events. Include links or references if available.

Describe your media skills and interests. What type of media opportunities are you interested in (e.g., TV, radio, podcasts, writing, public speaking)?

Upload sample work that showcases your media skills (e.g., photos or video clips).

Upload sample work that showcases your media skills (e.g published articles or campaigns).

Availability

Days and times you are typically available for media opportunities.

Are you willing to travel for in-person opportunities? Do you have any geographical limitations?

References

Provide 1-2 professional references who can speak to your expertise and media readiness.

Additional Information

Provide any further information you believe is relevant to your application.

I consent to have my information shared with media outlets seeking healthcare professionals for media opportunities.

I agree to the MediaRX terms and conditions and understand that joining the network does not guarantee media opportunities.

MediaRX™ Healthcare Network Application

Are you a healthcare professional ready to amplify your voice and share your expertise through media?

MediaRX™ is your gateway to exciting media opportunities—whether it’s appearing on television, being featured on top podcasts, or captivating audiences as a public speaker.

By joining the MediaRX™ Healthcare Network, you'll connect with media outlets actively seeking trusted and credible healthcare experts like you. Don't just watch the conversation—be a part of it!