Share Your Story

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Share Your Story

Please share your story concerning pregnancy loss and/or infertility.

Email *

What is your full name? (If published, your story will include only your first name, and only with your permission) *

If you work in education, what is your role? *

Classroom Teacher

Classroom Aide

Guidance Counselor

School Psychologist

Office Staff

Child Study Team Member

Other - I do not work in education

Other:

If you do NOT work in education, what is your job? *

Please tell your story. *

If your story is published, do you want your first name included or would you rather remain anonymous? *

Please include my first name.

I wish to remain anonymous.

We love to include photographs with our stories. Please submit yours to jackie@starthealingtogether.com. Please include your full name and email address as written on this submission form.

How did you hear about Start Healing Together? *

A friend or family member

Social media

Presentation

Union representative

Employer

Other

Other:

>> 1 << I give permission for Start Healing Together™ to share my story (in part or in full), my first name and photo (if my consent is given) on its website and/or all social media pages. >> 2 << I reserve the right to request for the post(s) to be taken down. >> 3 << I agree to notify Start Healing Together™ at jackie@starthealingtogether.com to submit a formal request for the removal of any aforementioned information. *

By checking this box, I agree to the above statement.

Required

A copy of your responses will be emailed to the address you provided.

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