Covid Safe MD Stories
Covid Safe MD is looking to amplify the voices of individuals who support mask requirements in healthcare settings. This form gives you the opportunity to share your story on social media and in advocacy materials, express interest in speaking to the press, and express interest in joining meetings with Maryland legislators and decision-makers.

If you are interested in participating but would prefer to supply your answers over the phone or in any other format that is more accessible for you, please send an email to: CovidSafeMarylandStories@gmail.com

This form collects your email address and will also ask if you would like to share your name and contact information. If you wish to share your story completely anonymously for social media, click here.

[Header image description: A gradient background that transitions from dark gray on the left to black on the right. There is a yellow outline of a megaphone on the left. On the right there are three lines of text. The first line is in yellow and reads "Covid Safe MD". The second line is in white and reads "wants to hear your story!" The third line of text is in yellow and reads "@CovidSafeMD".]
Email *
Social Media and Advocacy Materials
Your voice is powerful. One way to effect change is by sharing your story on social media and in advocacy materials. This section gives you space to detail your experiences during the pandemic and why you support mask requirements in healthcare. There are many different prompts. Feel free to pick and choose the ones to answer based on your available time/energy and what you find most compelling.

By filling out this form, you give permission for COVID Safe MD to use the information you share in social media and advocacy materials for COVID protections in healthcare settings and contact you at the provided email address if needed for any clarifications. Stories may also be edited for length and clarity, but we will never change the substance of your message.  Please refrain from including specific names of doctors and/or health institutions in your responses.

We appreciate the time and energy that you are putting in to responding to our questions. COVID Safe MD will work to share as many stories as possible within the capacity of our team.
Can you tell us about a time you had a negative healthcare experience related to the lack of COVID protections?
ex. Provider refusing to mask; catching COVID or other illnesses at a medical facility; needing to wait in crowded waiting rooms with unmasked people; the ways that lack of COVID safety in healthcare intersects with racism, sexism, ableism, transphobia, homophobia, and classism in healthcare
What care, if any, are you not accessing because of the lack of COVID protections in healthcare settings? 
ex. Postponing screenings like colonoscopies; not going to appointments where you would need to unmask, such as dental care; not going to the ER when you have had an emergency situation
How would you like your story to be attributed on social media? *
Type your name exactly as you want it to be printed

ex. Jane
     Jane D.
     Jane Doe
    Ms. Jane
    Dr. Jane Doe, MD
    Anonymous
What are your pronouns?
ex. she/her
      he/him
      they/them
Enter your Twitter handle if you would like to be tagged in our Twitter post featuring your story:
Enter your Instagram handle if you would like to be tagged in our Instagram post featuring your story:
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