Health Care for America NOW! | Tell us your story!

Tell us your story

We all have a story about a health care situation that makes us angry. High deductibles, claims denied, rising costs . . . you name it. We want to share your stories with members of Congress to help illustrate why we need health reform now, more than ever before! We want to raise the voices of people who are ready for quality, affordable health care we all can count on

Email: *

First Name:

Last Name:

Address:

City: *

State/Region/Province:

Zip / Postal Code: *

Phone:

Are you a::

  Patient/Consumer
  Health Care Provider
  Small Business Manager/Owner

Type of problem: *

Your Story: *

Anonymous:

I would like to remain anonymous. Please do not publish my name.

Media:

I am interested in speaking to members of the media.

* denotes required field

* Stories are subject to editing for length and language. We may not be able to publish all stories. We appreciate your submissions, and we will do what we can make sure your voice is heard. We will not publish your last name, however if you would like to remain anonymous please indicate that on the form.