Miracles In Sight - Share Your Story
Contact Information
Name
*
First Name
Last Name
May We Contact You Regarding Your Story?
*
Yes
No
If Yes, Please Provide Your Email Below
If you prefer a phone number, you can provide that instead.
Name of Donor or Recipient
*
First Name
Last Name
Your Relation to the Donor or Recipient
Self (Recipient)
Self (Live Tissue Donor)
Spouse or Significant Other
Parent
Child
Friend or Loved one
Other
Your Story
Your Story
Please Share About the Impact of the Donation Process On Your Loved One, Self, Family, and / or Community. How Has Life Changed Since They Became a Donor or Recipient?
Was the Donation Experience Positive or Negative?
Please Share About the Donor or Recipient's Life Prior to Donation
An Opportunity To Share About Their Passions, Hobbies, Personality, and, If You Feel Comfortable, the Circumstances That Led To Transplantation or Donation
Describe Your Experience with the Miracles In Sight Team
Did You Feel Supported and Informed Throughout the Donation Process By Our Team?
Share Photos To Include with Your Story
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Sharing Your Story
By Sharing Your Story, We Can Not Only Educate Others About the Importance and Impact of Eye, Organ and Tissue Donation, But Also Help To Connect Families with Community, Resources, and Support Systems. Sharing Your Story Helps Share Hope and Foster Conversations Around This Often Difficult Topic.
May We Share Your Story (and Photos, If Applicable) On Our Website?
Yes
No
Maybe, Let's Talk About It
May We Share Your Story (and Photos, If Applicable) On Our Social Media?
Yes
No
Maybe, Let's Talk About It
May We Share Your Story (and Photos, If Applicable) On Other Materials? I.E. Presentations At Events and with Our Partners, Marketing Materials, Newsletters, Etc.
Yes
No
Maybe, Let's Talk About It
Would You Be Interested In Speaking About Your Experience at Future Donation Awareness or Educational Events? (In-Person or Via Video)
Yes
No
Maybe, Let's Talk About It
Would You Be Interested In Participating In a Phone and / or Video Interview About Your Experience?
Yes
No
Maybe, Let's Talk About it
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