Interview Release Form

In the year stated above, I participated in an interview with Safe Space Radio for the purpose of public distribution via radio broadcast.

I understand that Safe Space Radio created and edited a digital copy of my interview as both a radio program and a podcast, which are currently publicly available via the web domain www.safespaceradio.com.

By signing this form, I grant all rights, title, and interests, including copyright, in my interview to Safe Space Radio.

Furthermore, I release Safe Space Radio and its assigns, successors in interest, employees, consultants, and any and all third parties authorized by the organization to conduct related public-health and media distribution activities from any and all claims arising out of their use of my interview, including, without limitation, claims for libel or invasion of privacy.

I understand that Safe Space Radio intends to donate all rights, title, and interests in the aforementioned radio program and podcast to the Harvard Medical Library, President and Fellows of Harvard College, where they will be preserved as a historical resource in the Center for the History of Medicine in the Countway Library and made publicly available with accompanying  written transcripts via its website.

I understand that I will not receive compensation now or in the future for my past participation in a Safe Space Radio program or the future donation of my interview to the President and Fellows of Harvard College.

I understand that if I have questions about this release, I can contact Anne Hallward, Executive Director, Safe Space Radio at ahallward@gmail.com for more information.