Free Media Request Form Template
Send journalists, podcasters, and bookers to one form instead of your inbox. Get all the details on first contact.
Preview
Media request
Thanks for the interest. Fill out the form and we'll respond within 2 business days.
Preview only — click "Use this template" to edit in the builder.
Great for
- Authors and creators handling press
- Startup founders fielding interview requests
- Bands and artists managing bookings
- PR teams qualifying inbound coverage
Fields included
- Your name*text
- Outlet / publication*text
- Your email*email
- Request type*select
- What's the story angle or topic?*textarea
- Deadlinetext
Questions about this template
What details should a media request form ask for?
Outlet, requester's role, the angle or topic, deadline, and preferred format (email interview, call, live recording). This template starts with those.
Use this template
Opens in the form builder. Free to edit and publish.
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