Share Your Story Submission Form
Stories like yours help recognize meaningful care, celebrate caregivers and care teams, and highlight the difference compassionate healthcare can make in our community. After you submit your story, Confluence Health Foundation staff will share it with the caregivers or care teams you recognize. You will have the option later in this form to let us know whether we may contact you about sharing your story more broadly.
Your Name
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First Name
Last Name
Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Tell us your story
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Do you give Confluence Health Foundation permission to contact you about potentially sharing your story publicly? Selecting "Yes" means Foundation staff may contact you, your story may be edited for length, clarity, or format, and you will review and approve any version before publication. You may also be invited to provide additional information, photographs, or an interview. Your story will not be published without your additional review and consent.
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Yes, Confluence Health Foundation may contact me about sharing my story in Foundation communications, such as print materials, digital publications, social media, website, fundraising campaigns, or community awareness materials.
No, I am sharing my story for internal purposes only, such as expressing gratitude to my caregivers or care team.
Submit
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