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Submit Your Personal Healthcare Story

Your story will help demonstrate to Members of Congress the health care needs of people with lupus.

General Rules
  • You must be 18 years or older. (Parents may submit their child’s story.)
  • You must be the author of your own story (it’s ok to have help with writing it but the story must be about you, not someone else).
  • Write clearly and concisely for a general audience. Use short sentences and common words.
  • Be brief. Your story can be no longer than 1,200 words (about one full standard size page of single spaced copy).
  • Understand that LFA cannot use every story submitted. However, LFA may be able to use your story for other purposes.
  • By submitting your story, you agree to these rules and the conditions and provisions contained in the author's release.
 
Your Contact Information: (* required fields)
Email Address:
   *
Prefix:
  
First Name:
  *
Last Name:
  *
Suffix:
   (e.g. M.D., R.N., Jr.)
Street Address:
 
City:
   *
State:
 
Zip Code:
 
County or Parish:
   (U.S. residents only)
Country:
  
Home Telephone:
  
Work Telephone
  

Mobile Telephone

 
Age
   (You must be 18 or older)
   
Release:
  * I have read the general rules and author release and accept all terms and conditions. By checking this box, I authorize the LFA to release my personal information and to use my story in any manner it deems appropriate. Authorization will remain in effect until I notify LFA otherwise. Withdrawal of authorization cannot not be made retroactive.
 
Your Story:
 
 
 

 
 
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