Share Your COVID-19 Story

Share Your COVID-19 Story
COVID Health wants to hear how COVID-19 has affected your life. Just tell us a bit about yourself in the space provided below. Selected entries will be published online!

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Tell us your story*

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Please provide the following information about yourself. (Only your name and location will be shared on covidhealth.com. All other information will remain confidential.)

Privacy Warning: Please realize that the COVID Health Stories are fully searchable via Google and other search engines. If you have do not wish to share your health information with the whole world (or at least the entire internet) then please post your story anonymously and do not include any information that is self-identifying in any way. We do not allow the deletion of content on this site, so think before you post.
Full Name*

First NameLast Name
E-mail*
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth

MonthDayYear
Gender

MaleFemaleTransgenderOther
Ethnicity (Check all that apply)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
Sexual Orientation

StraightGay/lesbianBisexualOther
Upload your photo to accompany your COVID Health Story

Upload a File

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(You do not have to include a photo but stories with photos may be highlighted on the COVIDHealth.com homepage.)

Please read the COVIDHealth.com Terms of Use. You must agree to abide by these rules in order to submit your story.
Do you agree to the Terms of Use?*

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