Planned Parenthood Story Submission

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Personal stories are critical when advocating to maintain or even expand access to the vital health services that Planned Parenthood provides. By sharing your story, you can play a significant role in the work we do.

There are many levels of comfort when sharing a personal story. Please share what you are willing, and indicate your permission levels where applicable. Please note: In sharing your story, keep in mind that your story — including your name if you provide it — may appear in public advocacy projects such as Planned Parenthood websites, brochures, or other printed material. Even if you do not provide your name, keep in mind that some information can reveal who you are, such as unusual details about you or others. Information shared here is used solely for advocacy work and should only be shared voluntarily. Planned Parenthood provides the same quality health care services to all, whether or not a patient wishes to share a personal story.

We will follow up to thank you and discuss next steps!

Name

Phone Number

Street Address

City, State, Zip (by providing this information, we are able to share constituent stories with your lawmakers who are making decisions about your health care) *

My Story *

Permissions: Please check ALL that apply

Yes, I give permission to Planned Parenthood Advocates of Oregon to use my story or any portion of it in any manner or media for any lawful purpose whatsoever. I confirm that I have written the story myself, and I release Planned Parenthood from any liability arising out of the use of my story.

Yes, I give permission to Planned Parenthood to publish my first name, last initial, and city with my story.

Yes, I give permission to Planned Parenthood public affairs staff to contact me about my story using the contact information I provided.

I certify that either: I am over the age of 18 and agree to the above.

Or, I certify that I am the parent or guardian of the minor participant named above and I agree to the above on behalf of the minor and myself.

Are you interested in getting involved in our work?

YES!! I am interested in volunteer opportunities with Planned Parenthood Advocates of Oregon.

By filling out this form, you'll become a member of the Planned Parenthood Action Network and receive messages, updates, and reminders to vote. Your name and contact information may also be shared with other like-minded organizations. By providing your cell phone, you agree to receive calls and texts to that number on Planned Parenthood issues and ways to get involved.

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