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SHARE YOUR VALLEY FEVER STORY
Have you or a loved one suffered from Valley Fever? Are you interested in sharing your story with our VFAF community? With your permission, responses may be shared on our website, social media pages, or featured in our YouTube series, "Interviews with Survivors of Valley Fever "
Name
Your answer
Email Address
Your answer
Phone Number
Your answer
Can we contact you for further information regarding your Valley Fever story?
Yes, by phone or email
Yes, by email
Yes, by phone
No
Clear selection
What is your connection to Valley Fever?
Survivor
Friend or Relative of Survivor of Valley Fever
Lost a Loved One to Valley Fever
Other:
Clear selection
Are interested in sharing your story with others? (In Print, Online, or on Camera?)
Yes
Yes, but not on camera
Yes, but anonymously
No, only with the Foundation
Other:
Clear selection
Your Valley Fever Story
Your answer
Would you be interested in doing an interview?
Yes
Yes, but not on camera
No
Clear selection
Do you have any advice you would like to offer to others in our community that are struggling with this disease?
Your answer
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