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SHARE YOUR STORY WITH MITSS

By sharing your experience with an adverse medical event, you may help other caregivers on their journey toward healing.

Clinicians and caregivers finding themselves on the "sharp end" of an adverse medical event may feel lonely and isolated.  Sharing your story with others can remind them that they are not alone.  This is your opportunity to tell other caregivers with similar experiences that there is hope.

What you share is up to you – feel free to write about your overall experience. Since the focus is on healing and moving forward, MITSS may opt not to use actual names of clinicians or institutions. 

If you would like to consider sharing your story, please fill out the form below.

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My Story is from the following perspective:
From the patient perspective
From the family member perspective
From the caregiver perspective (Doctor, Nurse, etc..)

 

* First Name:

Last Name:

Address:

* City:

* State:

* Zip:



* Email:

* Please Confirm Your Email:

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In the event that MITSS selects your story for possible publication, we would like to contact you.

I prefer to be contacted via:

Email
Phone

If By Phone, Please Provide Phone Number:

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Please provide your story here: (You may copy and paste from a word document)

I hereby voluntarily and without any promise of consideration (monetary or otherwise) submit my story to MITSS and third parties under its direction for the purpose of having it considered for publication. Not all stories can be published. Once my story is submitted, it may not be protected by privacy laws. I certify that I am at least 18 years old. I have the right to receive a copy of this consent.


If you have any questions about "Share Your Story", please feel free to contact us directly. Thank you for sharing with us.