Story Bank

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Story Bank

Telling your story is a great way to make an impact in the fight against Alzheimer’s and other dementias . Fill out the Storybank form below with your information and connection to Alzheimer’s disease and we may contact you with opportunities to share your story. It may make a difference in someone else’s life.

Email *

First and Last Name *

Email *

Phone number

Street Address

City *

State *

Zip *

County

Please check each role in which you identify with (you can select more than one). *

Individual with memory loss

Family caregiver

Long-distance caregiver

Healthcare professional

Family member of someone with Alzheimer's or other dementia

Friend of someone with Alzheimer's or other dementia

Alzheimer's Association volunteer

Alzheimer's Association Staff

Other:

Required

If "other" please explain

Please share your experiences within the role(s) you checked above.

Please check off which Alzheimer’s Association services you have used (check as many as you have used):

Helpline (toll free number or website)

Care Navigation (Alzheimer's Navigator)

Caregiver Support Group

Early Stage Support Group

Social Engagement Program

Professional Training

Please share your story with us

I would like to be contacted by the Alzheimer’s Association for print and media opportunities.

By checking this box, you give the Alzheimer’s Association permission to use this story in Association related materials.

Submit

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