Submit Your Story

Share your testimonial with us!

*By submitting comments or any photo, video, or other material:

1. I certify that I am at least 18 years of age.
2. I represent that any statements I submit are truthful and reflect my personal experience.
3. I grant the National Alliance for Care at Home, the National Alliance for Care at Home Foundation, and their affiliated partners (collectively, the “Alliance”) the right use my name, state, photo (if provided), video (if provided), and statements for advocacy and promotional purposes. The Alliance may edit your submissions for brevity and you have no right to approve the editing process and will have no input or control over the content used by the Alliance. This grant includes without limitation the right to edit, mix, or duplicate and to use or reuse my name, likeness, image, voice, and statements in whole or part as the Alliance may elect. The Alliance will have complete ownership of my statements and testimonials, including copyright interests. The rights granted to the Alliance are perpetual and worldwide.
4. I have the right to agree to these terms and grant the rights in these terms, and the Alliance has no financial commitment or obligation to me as a result of these terms. I give all clearances, copyright, publicity rights, and otherwise, for the use of my name, likeness, image, voice, and statements, and I expressly release the Alliance and its officers, employees, agents, licensees, assigns, designees, and representatives from any and all claims known and unknown arising out of, or in any way connected with, the above granted uses and representations.
5. I agree not to disclose any personally identifiable information about any patient, such as name, address, phone number, email, medical record number, diagnosis, treatment, or health status, unless I have obtained the prior written consent of the patient or the patient’s legal representative. If I do include any personally identifiable information about any patient in my submission, I represent that I have the authorization from the patient or the patient’s legal representative to do so, and that I have complied with any applicable laws and regulations regarding the privacy and security of such information. I acknowledge that the Alliance is not responsible for verifying or safeguarding any patient information that I provide, and that the Alliance may use, disclose, or publish that information in accordance with these terms and its privacy policy. I indemnify and hold harmless the Alliance and its officers, employees, agents, licensees, assigns, designees, and representatives from any and all claims, damages, liabilities, costs, and expenses arising out of, or in any way connected with, my disclosure of any patient information.