COVID-19 Story Collection Form
Thank you for your interest in making the case for additional support for children and families dealing with the challenges of COVID-19. We know this pandemic is incredibly difficult for many families, and we want to help system leaders and policymakers become aware of the struggles families are facing.

Specifically, we are looking to develop media stories. We've developed this short questionnaire to help you identify a story that you could share with the media. Please fill this form out and an Alliance representative will be in touch with you or if you prefer you can

Media stories are usually written in three parts:
Introduction
Story- key messages
What's Needed / Call to action

The information below will help you craft an op-ed or a story for submission to a news or media outlet. We can help you in refining and submitting your story to media outlets for publication.

Looking forward to working with you.
Email address *
Untitled Title
Please affirm your interest and willingness to work with our team to develop a story to share with the media. *
Name (First and Last) *
What is your role? *
Where do you live? (City) *
Where do you live? (State) *
Zip Code *
Phone Number including area code
Tell Us About You and Your Family!
Please share about you and your families experiences dealing with the challenges of COVID-19. *
What are the ages of your children?
Please indicate whether COVID-19 has affected you and your family in the areas below: (Mark all that apply.) *
Required
If applicable, how has COVID-19 affected housing for you and your family.
If applicable, tell us how COVID-19 has affected the education of your child or children.
If applicable, tell us how COVID-19 has affected the well-being of your child or children.
If applicable, tell us how COVID-19 has affected the mental health of you or your family.
If applicable, tell us how COVID-19 has affected you in obtaining food and meeting the basic needs for you or your family.
If applicable, tell us how COVID-19 has affected employment for you or others in the household.
If applicable, tell us how COVID-19 has affected the social life for you and your family.
If applicable, tell us how COVID-19 has affected the physical health of you and your family.
If applicable, tell us how COVID-19 has affected access to services for you and your family.
What do you think system leaders and policymakers should do to help families during this crisis? Here are some examples, or please offer your own ideas: *
Required
What is your family's greatest need or concern that hasn't been addressed by systems leaders and policymakers in response to COVID-19 so far? *
What's one thing you wish your Congressperson should know about why families need more help, especially now?
What (if anything) gives you hope during this crisis? *
Next Steps
The Alliance will have someone from our team get in touch with you to talk more with you about your story based on your responses above.
Know you are not alone.
These are difficult days for so many families across the country. Please know you are not alone during this time. Reach out to the people around you- such as your neighbors, your co-workers, friends and others. Keep your connections strong and know we will help you share how this is impacting you and those you love.
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