How has Family Tree Clinic impacted your life?
We are collecting stories from patients, volunteers, and community members about how Family Tree Clinic has impacted lives. Your story will be used in promotional campaigns to support and expand our services. Thank you!
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Name *
Email *
We only use first names when attributing stories to people. It is okay to use your first name or would you like to be anonymous? *
Are you a... *
How has Family Tree impacted your life? *
What do you tell other people about Family Tree?
Would you be willing to share a photo of yourself to be used with your story?
We are creating a video that includes the stories of patients talking about their experience at Family Tree. Would you be willing to share your story in your own words on video?
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I hereby grant permission to Family Tree Clinic, its officers, employees, agents, representatives, contractors, successors, and licensees to share my story/quote about how Family Tree has impacted my life in all forms of media for promotional purposes. I acknowledge and represent that I am over the age of 18, that I have read this, that I understand its terms, and that I check the box below knowingly and voluntarily on my own behalf. *
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