Collect a beneficiary's story, their review of the written version, and ticked release permission — signature name and date kept with every quote.
Quick answer
Use it before publishing anyone's story: the beneficiary tells it, reviews the written version, then ticks exactly what may be used — naming level, channels, duration — with a signature name and date kept beside every quote so marketing can prove the story was given, not taken.
Impact stories are someone's dignity loaned to your newsletter. This form walks the full circle: the person tells their story, your team writes it up, and the subject reviews the actual text before ticking what may be used — name, first name only, or anonymous — where it may appear, and for how long. Signature name and date travel with every quote, so marketing can prove the story was given, not taken.
Sample form preview — live and ready to fill in.
Everything you need to run this template.
The story begins as the subject's own answers, in their words.
No quote goes out the subject hasn't seen written down.
Name, first name or anonymous — chosen, not imposed.
Pre-publication withdrawal updates the trail, no explanation required.
From copy to deliverable in four steps.
Copy it in; add your written-version step before release.
Subject answers in their own words, at their own pace.
The written version comes back for corrections before any tick.
Signature, identity choice and scope ride with every published quote.
Pick your role — see how it fits your workflow.
Publish stories whose permission you can prove.
Keep authorship over how your experience is told.
Share case studies along consent lines others can verify.
What makes this template work as a professional deliverable.
A preview of the real questions in this form — exactly what respondents see.
