The Drew Barrymore Show

ARE YOU GOING THROUGH A ROUGH BREAKUP? DO YOU HAVE A DATING QUESTION YOU'VE BEEN DYING TO ASK? TELL US MORE

The Drew Barrymore Show is looking for people living in the NYC/TRI-STATE area to ask relationship questions they may have!!

First Name

Last Name

Address (Optional)

City (Optional)

State (Optional)

Zip Code

Primary Phone No.

Mobile Phone No. (Optional)

Secondary Phone No. (Optional)

Birthday

Tell us your story (Maximum 250 words). Please limit your response to information you would be comfortable sharing on air.

0 / 250 words

attach photo

Optional

Are you willing to appear on the show?

Yes

By submitting any material and personal information, including but not limited to, uploading video, photos or stories, I give my consent that all such content may be published, edited, or otherwise used by Big Ticket Pictures, Inc., in whole or in part, on or in connection with the Drew Barrymore Show (including on air) and/or its affiliated digital properties and partners in all media and I represent that I have the right to grant such rights. I understand and acknowledge that I will receive no payment for any suggestions, ideas, or other content submitted.

By pressing submit, you confirm that you have read and agree to CBS Interactive's Terms of Use and acknowledge the data collection and usage practices outlined in CBS Interactive's Privacy Policy. Any material or personal information submitted will be used in part for the purpose of evaluating whether to invite you to appear on the show.

The Drew Barrymore Show

ARE YOU GOING THROUGH A ROUGH BREAKUP? DO YOU HAVE A DATING QUESTION YOU'VE BEEN DYING TO ASK? TELL US MORE

Want to be on the Show?

Do You Know of Someone Who is a True Unsung Hero?

Need Advice? Ask a Drew's News Deskpert!

Nominate Someone for Designed By Drew!

Tell Drew What to Test Out for Drew's Reviews!

Submit a Show Idea to Drew's Fan Suggestion Box!