Submit Your Keratoconus Story
Raise keratoconus awareness and help other patients by sharing your experiences on our blog. Please send one or more photos for the blog post to our email: story@keratoconusgroup.org

Visit our website: https://www.keratoconusgroup.org/

Name: *
First and last name. this will be added to your story. nicknames are not accepted.
Your answer
Email address: *
We will use this to contact you.
Your answer
Your Keratoconus story: (Must be at least 1000 characters) *
You can write anyhing about Keratoconus, about your diagnosis, any treatments you had or your are going to have, and how you are living with this disease. Please send one or more photos for the blog post to our email: story@keratoconusgroup.org
Your answer
Facebook, Twitter or Google+ address: *
At least one online profile is required.
Your answer
How did you hear about us?
This is optional.
Your answer
Tell us a little about yourself:
A short bio for your blog post. This is optional.
Your answer
By submitting your story and photos, you agree that they may be published and shared on the Keratoconus Group blog and in our online communities and social profiles. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms