Share your Story! - Conquering CHD

Conquering CHD exists to conquer the most common birth defect and sharing patient and family stories is a large part of our awareness work. Your #CHDVoice matters and it should be heard!

Whether you are a patient, family member, bereaved family member, or friend – we want to hear from you. Sharing your story with Conquering CHD is a way to support the greater congenital heart disease community. Your photos and story may be used to spread awareness in educational materials, e-newsletters, social media, or programming materials.

Name of Patient*
First Last
Age of Patient*
Please enter a number from 0 to 100.
Diagnosis
Name of Parent/Caregiver
If subject is a minor
First Last
Email
Please indicate your relationship to CHD (select all that apply)
- Patient
- Family Member
- Bereaved Family
How did you become connected with Conquering CHD?
*
Share your patient or family member story in 600 words or less. Consider your experiences, how you felt, and how they affected your journey. If you are the family member of a patient, how did CHD affect your family unit? Be sure to include the patient’s diagnosis, treatments, surgeries, and other interventions. Don’t forget to share successes and triumphs along with the difficulties. Words are powerful and sharing your story can impact so many!
Upload your photo(s) here:*
Upload at least 3 photos of good quality. Photos should show a range of activities (in the hospital/clinic, daily life, favorite hobby, etc.), be clear, well lit, and full size. Medical photos are accepted. Please do not submit photos that feature persons or places that cannot give consent to share the photos (ex: other people in the background during hospital or clinic visit).
Drop files here or

Accepted file types: jpg, gif, png, avi, flv, wmv, mov, mp4.
I hereby grant Conquering CHD royalty-free, non-exclusive, perpetual (for the duration of the applicable copyright) license to reproduce the photograph(s), to incorporate the photograph(s) into one or more Collective Works (including but not limited to newsletters, websites, and any other media or publications as the above named organizations deem appropriate for promoting advocacy activities), and to reproduce the photograph(s) as incorporated in the Collective Works. The above rights may be exercised in all media and formats whether now known or hereafter devised. The above rights include the right to make such modifications (including but not limited to cropping or altering the photograph(s) as are technically necessary to exercise the rights in other media and formats.
*
- I have read and understand the above: (Check box)
By completing this form, you are also considered a Conquering CHD partner and will be added to our partner database.
- I do not wish to receive any email communication from Conquering CHD
- I do not wish to receive any postal mail from Conquering CHD

Conquering CHD Stories

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