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Appendix M

NEW MEDIA INQUIRY FORMAT (SAMPLE)

This format is intended as an example only and should be adapted to local needs and SOPs. In addition to query forms, PAOs should maintain a separate log of all inquiries.

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MEDIA QUERY SHEET
Query Number:____________
 
Deadline:_________________
 
CALLER'S NAME:_______________________________________________________
 
CALLER'S NEWS ORGANIZATION:__________________________________________
 
CALL TAKEN BY:_________________TIME:_________________DATE:_________________
 
QUESTION (use reporter's precise wording):___________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________
 
RESPONSE (if written release is made, attach a copy):___________________________
___________________________________________________________________________
___________________________________________________________________________
_______________________________________
 
SOURCE OF INFORMATION/COORDINATION (e.g., G-3, surgeon):___________________
___________________________________________________________________________
 
RELEASED TO:___________________________________________________________
 
TIME/DATE:______________________________________________________________
 
RELEASE METHOD: In Person________ Phone_____________ News Release_______
 
RELEASED BY:________________ RELEASE NUMBER:___________________



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