Share Your Story

Thank you for sharing your story with us! Your experience can inspire and support others on their journey. Please fill out the form below and confirm your consent to share your testimonial across our digital channels.

Name

We will only use your first name

First Name

Last Name

Social Handle(s)

Let us know what platforms and handles you have so we can tag!

Email

For internal purposes only

Tell Us Your Story

Include your condition(s), when you were diagnosed, the challenges you overcome and how you are feeling today. Include any hobbies, interests or ways you help spread advocacy, too!

Consent

Please read and check each box to confirm your consent:

I consent to the use of my name, image, and story on Chronic Creator Club’s digital channels (e.g., social media, website, newsletters, etc.).

I agree to allow Chronic Creator Club to edit my testimonial for clarity or length if needed, while preserving the message and intent.

I confirm that all information provided is my own story and does not infringe on any third-party rights.

E-Sign

Type your full name again to e-sign this story form consent and release.

First Name

Last Name

Share Your Story

Thank you for sharing your story! We will send you the post and copy before anything is shared. <3 CCC

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