About this template
Handling incoming press inquiries, interview bookings, and asset requests requires a structured approach to ensure no deadline is missed. This Media Request Form template helps public relations and marketing teams centralize inquiries from journalists, bloggers, videographers, and content creators. By capturing essential details upfront—such as media type, specific asset requirements, publication deadlines, and contact information—your team can prioritize requests accurately and respond faster.
Built for seamless collaboration, this template eliminates back-and-forth emails by gathering all project specifications in one submission. Whether you are coordinating high-profile press interviews, supplying high-resolution brand assets, or managing daily media relations, Doc2Form enables you to transform this template into a live Google Form instantly. Keep your PR pipeline organized and ensure every media outlet receives the prompt, professional attention they need.
Key features
- Capture contact and outlet details upfront
- Specify exact media formats and asset requirements
- Track strict publication deadlines and delivery dates
- Standardize press intake for faster PR response times
- Instantly convert into a ready-to-use Google Form
Use cases
- Coordinating press interviews and expert commentary requests
- Fulfilling high-resolution logo, brand asset, and media kit inquiries
- Managing blogger and influencer review sample requests
- Handling general public relations and newsroom inquiries
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Provide the best email address for our team to reach you.
- Phone Number (Short answer)Include your direct phone number or cell for urgent inquiries.
- Company or Media Outlet (Short answer)Name of the publication, network, blog, or organization you represent.
- Department or Desk (Short answer)E.g., News, Lifestyle, Tech Desk, Podcast.
- Media Type (Dropdown)Select the format that best describes your medium.
- Media Description & Request Details (Paragraph)Provide an overview of your story, interview topics, or specific assets you need.
- Date Needed (Date)Specify your deadline or publication date.
- Preferred Delivery Method (Multiple choice)How would you like to receive the requested assets or follow-up?
- Additional Comments or Special Instructions (Paragraph)Share any extra context, embargo details, or special requirements.
FAQ
How do I customize this media request template for my organization?
With Doc2Form, you can instantly turn this template into a Google Form, allowing you to add, edit, or remove questions directly within the Google Forms editor to fit your exact PR workflow.
What information should journalists provide in a media request?
A strong media request should include contact details, media outlet name, specific project scope, required assets or interview subjects, and the hard deadline for publication.
Can I receive email notifications for new media requests?
Yes! Google Forms allows you to enable instant email notifications so your PR or communications team is alerted immediately whenever a new inquiry is submitted.
Is this media request form template completely free?
Yes, this template is free to convert and deploy using Doc2Form's instant Google Form generator.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.