The Effects Of ME Campaign
How This Works:
The aim is to provide a glimpse of the practical ways in which ME affects your daily life.
Simply fill in the form and press submit.

Your quote will be used to create ME awareness graphics to be shared on social media.
Your quote will be published anonymously

NOTE: By submitting this form you agree to your quote being used on an image that will be shared publicly by me and others on social media for awareness purposes. Your name and email will remain private, it is only required so that I may contact you about your quote, if necessary.
Sign in to Google to save your progress. Learn more
Email *
Your name *
Your Quote
The information you provide below will be added to the awareness graphic and will be shared on social media.
Example: "When you can't do a thing today because you did a thing yesterday" or "when you get palpitations from brushing your teeth"
You know you have ME when... (what effect does ME have on your daily life and activities?) *
Thank you!
Thank you for sharing your experience. You can see the entire collection at and you are welcome to use them for awareness purposes as long as they remain unedited and in tact.

* This campaign was created by Char (Chronically Hopeful). Visit to read the terms of use if you plan on using them anywhere other than on social media. Please get in touch if you have any questions, email 
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy