Form
Warriors Speak Out
Share your Story
Name
First Name
Last Name
Email
example@example.com
What best describes you?
I live with sickle cell disease.
I live with another chronic illness.
I live with more than one chronic illness.
I am a caregiver.
I am a partner/spouse.
I am a family member.
I am a friend/supporter.
I am a healthcare provider/professional.
Other:_____________
Condition(s) You're Living With or Supporting (if you wish to share)
Share Your Story! (Please share, don't be afraid to be yourself)
Do you have a message, mantra, or quote you live by? (optional, but inspiring to other!)
What advice would you give to someone newly diagnosed or supporting a warrior?
Social Media Handles
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Consent Checkbox
I give permission to share my story and photo (if included) on the Warriors Speak Out website and social media channels.
I do not give permission to share my story and photo (if included) on the Warriors Speak Out website and social media channels
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