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Media request form template

Manage press and media enquiries with this media request form template. Collect the outlet, topic, format, and deadline so the right person can respond with useful information.

Read the template guide
Use this template Free to customize. No code needed.

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A LITTLE GUIDANCE

Make the most
of your next ask.

Questions to consider for your media request form

Use these questions as suggestions when editing your copy. Keep the ones that fit your purpose and add any details your process needs.

  • Which outlet or organization are you contacting us from?
  • What topic, interview, or material are you requesting?
  • What is your deadline and preferred contact method?

How to use the responses

Send the request to the person responsible for that topic. Confirm availability and what you can share before promising an interview, statement, or asset.

How to customize and share this template

  1. Explain which requests belong in the form and who will review them.
  2. Collect the item or issue, the required date, and the details needed to decide the next step. Add a reference or supporting file only when it will help the reviewer.
  3. Write an ending that explains what happens next. Connect the response to a place your team checks and agree who owns follow-up.

Make it yours with Youform

Use consistent request fields

Replace loose messages with editable questions, choices, dates, and numbers that match the information your team needs.

Show the right follow-up

Use conditional logic for different request types, so people only answer questions relevant to their request.

Bring requests into the workflow

Connect Google Sheets, Slack, or Zapier to make new submissions visible in the tools your team uses.

Start free with unlimited forms and responses, subject to fair use. See Youform plans and features for the details.

Frequently asked questions

What details help a team respond to a media request?
The publication, subject, requested format, deadline, and contact details are a useful start. Specific questions help the team decide who should respond.
Can I customize this form template?
Yes. Choose Use this template to make your own copy in Youform. Edit the questions and colors, review the whole flow, then share a link or embed it on your website. See Youform plans for advanced features.
Does a submitted request mean it has been approved?
No. Submission records the request. Review, approval, availability checks, and fulfillment are separate steps unless you configure an external workflow for them.
How should I handle urgent requests?
Explain which channel people should use when they need a faster response than the form can provide. Within normal requests, use a requested date and a reason for urgency so the reviewer has useful context.

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