Media Request Form: Student Health Care Center » Media Request Form » Student Health Care Center » College of Medicine

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Interview/Video Shoot/Image Request Form

If you are a student reporter and/or member of the media and would like to request interviews, video shoot time, images and/or a logo from the University of Florida Student Health Care Center, please complete and submit the following form. Please note that due to the volume of requests received not all may be accommodated.

Name*
First Last
Email*
Phone*
Name of media outlet
Requesting:*
DEADLINE: Last possible date for interview/video shoot/receipt of images*
MM slash DD slash YYYY
DEADLINE: Last possible time for interview/video shoot/receipt of images*

:

PLEASE NOTE: Due to staffing and privacy restrictions, the majority of videos may only be shot on weekdays between 5 p.m. and 6 p.m.
Interview platform (for staff interviews only)
Availability (for in-person staff interviews only)
Comments*
Include interview topic and 1-5 questions, video shoot scene preferences or other requests here.
Name
This field is for validation purposes and should be left unchanged.

Student Health Care Center

UNIVERSITY of FLORIDA

Media Request Form
Student Health Care Center

Interview/Video Shoot/Image Request Form