Share Your Covid Narrative

Thank you for your interest in sharing your story!

The act of sharing your story is a powerful tool in medicine and research. Sharing your experiences helps to highlight shared experiences and important themes that researchers can use to promote health equity. Storytelling is also often a therapeutic experience for the one sharing their story, and to those reading the story.

Informed Consent: By sharing your story you are agreeing to allow the Collaborative for Cardiovascular Health Equity to publish your story in order to promote health equity and work to lessen disparities that are often highlighted through narratives. In the questions below, you will be given an option to remain anonymous, which means that we will not include any information that will reveal your identity when publishing your story. After reading some stories, we may want to contact the author to collaborate with them to develop their story into a full narrative. In the questions below, you will be given the option to select how you would like to be contacted, or if you do not wish to be contacted at all.

Click the box to certify that you understand the informed consent statement above, and still wish to share your story.

I agree to the terms above and wish to share my story

Please Type Your Name (you can leave this blank if you would like to remain anonymous)

What is your age?

What is your Zipcode?

What is your profession?

How did you hear about the Collaborative for Cardiovascular Health Equity?

Facebook page

Facebook Ad

COVE NP Townhall

Temple affiliate

Other

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If you marked Other, please write how you heard about the Collaborative for Cardiovascular Health Equity.

The Collaborative for Cardiovascular Health Equity may have particular interest in your story and collaborating with you to develop your story into a longer narrative. If this is an opportunity that you are interested in, please select your preferred method of communication below, and enter your contact information in question #7. If you are not interested in such an opportunity, please select, "I prefer not to be contacted."
How would you prefer to be contacted?

Phone

I prefer not to be contacted

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Please enter your contact information for your preferred method of contact below. If you do not wish to be contacted, please leave this field blank.

Please enter your story:

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.