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Guest Intake Form

Black Women’s Health Podcast Black Women’s Health Podcast

Black Women's Health is a podcast hosted by Dr. Rahman, a board-certified OB-GYN, who focuses on improving women's health outcomes through clear analysis, practical insight and honest conversation.

While the podcast centers on Black women because of persistent racial health disparities, the goal is broader: to move beyond simply naming problems and toward identifying strategies, solutions and informed choices that women can actually use.

Thank you for your interest in being a guest on Black Women's Health .

This form help us understand your work and how it aligns with our mission. Submission does not guarantee an interview or publication

e.g. Author / CEO / Dancer / Mom

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Podcast Guest Agreement and Release

By submitting this form you are agreeing to our Podcast Guest Agreement and Release.

PODCAST GUEST AGREEMENT AND RELEASE

I do hereby agree, consent to and grant to the Producer hereunder all rights related to the recording and broadcast or other distribution of reproduction(s) of my voice, photograph, likeness and performance as part of my participation as a guest on the audiovisual program entitled Black Women’s Health Podcast (the “Program”). I hereby acknowledge and agree:

  1. The host of Black Women’s Health Podcast is the sole owner of all rights in and to the Program, and the recording(s) thereof, together with any materials prepared for the Program (“Materials”) are “Work(s)-Made-For-Hire” within the meaning of the United States Copyright Act f(17 USC §101, et. seqor all purposes; and Producer has the unfettered right, among other things, to use, promote and distribute the Program one or more times in any and all media or formats and modes of transmission whatsoever, through-out the world, in perpetuity.
  2. I will receive no compensation for my appearances on and participation in the Program.
  3. I hereby waive the opportunity or right to inspect or approve the content of the Program.
  4. Nothing contained in this Podcast Guest Agreement and Release shall be construed to obligate Producer to use or exploit any of the rights granted or acquired herein, or to make, sell, license, distribute or otherwise use the Program or Materials whatsoever.
  5. My name and likeness may be used in advertising and promotional material for the program, but not as an endorsement of any other product or service.
  6. I hereby release and discharge Producer, together with all of Producer's principals, share-holders, officers, employees, agents, successors, heirs, assigns and affiliates from any and all liability arising out of or in connection with the making, producing, reproducing, processing, exhibiting, distributing, publishing, transmitting by any means or otherwise using the Program and Materials.
  7. I am eighteen years of age or older, that I am fully competent to execute this agreement, and that no other agreements currently exist which would prevent my transferring these right to you, or your successors and assigns. I acknowledge that you intend to rely on this release, and the grant of rights herein contained, and shall incur significant costs in production of the Program in reliance upon same. As a result, I agree not to institute any legal action to contest the rights conveyed to you herein.

Electronic Signature
By typing my full name above and submitting this form, I acknowledge that I have read and understand the contents of this release and am executing same of my own free will.

Electronic Consent on: 01/28/2026 2:35 a.m.

This attorney-drafted podcast guest release is furnished courtesy of Easy Legal For Podcasters.