Request Dr. Simmons | Gettheskine

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Request Dr. Aleta Simmons

Speaking • Workshops • Media • Brand Collaborations

Dr. Simmons is a board-certified dermatologist, speaker, and educator who loves sharing her expertise on skin health, wellness, and beauty—especially as it relates to Black women and underserved communities.

SECTION 1: Contact Information

First name

Last name

Email

Phone

Company name

Website or Social Media Handle

SECTION 2: Type of Request

Please select the nature of your request

SECTION 3: Event or Project Details

For Speaking/Workshop Requests

Event Title or Name

Event Date(s) and Time(s)

Event Location (City, State, or Virtual)

Audience Type and Size

Topic(s) You’d Like Dr. Simmons to Cover

Format and Duration of Talk

Is this a paid opportunity?

Yes

No

Negotiable

Honorarium or Budget

For Brand/Media Requests

Brief Project Description

Target Audience

Deliverables Requested

Instagram Post

Instagram Story

Video or Reel

Speaking/Panel

Product Review

Email Feature

Blog or Article

Other

Timeline or Preferred Deadline

Is this a paid collaboration?

Yes

No

Negotiable

Budget or Compensation

SECTION 4: Additional Details

Why do you think Dr. Simmons would be a great fit for this opportunity?

Attach any flyers, media kits, or supporting materials

Anything else we should know?

SECTION 5: Consent & Next Steps

I understand that submitting this form does not guarantee acceptance or availability.

I give permission to be contacted regarding this request.

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