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Your Patient Story

Submit Your Patient Story

Please note: all submissions are reviewed by Patients Rising before being posted to the site.

All fields are required except where indicated.

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Butterfly
Cat
Coffee
Dog
Hands
Heart
Mountain
Rainbow
Stones

Profile Image

First Name

Email (will not be published)

State

ZIP

Diseases (check all that apply)

Blood Disease
Bone / Muscle Disease
Cancer
Chronic Pain
COVID-19
Ear / Nose / Throat Disease
Endocrine Disease
Eye Disease
Gastrointestinal Disease
Genetic Disease
Heart Disease
Immune Disease
Kidney Disease
Liver Disease
Lung Disease
Mental Health
Migraine
Neurological Disease
Rare Disease
Reproductive Disease
Skin Disease
Urological Disease

Issues (check all that apply)

Abuse (Mental, Physical, Elder)
Access to Expert Providers
Addiction / Substance Abuse
Biologics / Biosimilars
Caregiving
Copay Accumulators
Copay Issues
Disability
Discrimination (nonmedical)
Financial Assistance
Food Insecurity
Gaslighting
Geography
Housing
Insurance
Insurance Coverage is Inadequate
ICER
Invisible Illness
Involuntary Hospitalization
Job Insecurity / Loss
Legal
Lodging
Medical Discrimination
Medical Records
Medicare / Medicaid Issues
Mental Health Access
Non-Medical Switching
Nursing Home / Assisted Living
Oral Parity
Out of Pocket Costs
Power of Attorney
Premium Payments
Rare / Underserved Disease
Rebate Sharing
Rebates / Safe Harbor
Social Security Disability
Step Therapy
Suicide / Self-harm
Surprise Billing
Transparency in Health Care
Transportation
Underserved Community
Uninsured

Your Story

Your Motivation or Inspiration

Optional - please add any links to your social media profiles, blog or websites (personal or organizational). Please use the complete address in each case, e.g. https://twitter.com/patientsrising. We recommend copying the address from your browser's address bar.

Facebook Page

Twitter Profile

Instagram Page

Blog

Website 1

Website 2

Optional - please upload up to 4 images that you would like to include with your story.

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