Share Your PKD Story 1. Thank you for sharing your story with us! The questions below will help us learn more about your story. If you choose not to answer a question, please leave the answer blank. 1. What is your relationship to PKD? 2. What has been your experience with PKD? (We are especially interested in hearing the unique aspects of your story - have you had a transplant, how many people in your family have PKD, when were you diagnosed, what is your health like now, etc.) 3. What have been the biggest challenges about dealing with PKD? 4. As you know, PKD doesn't affect just one person, but an entire family. How has PKD affected your family? 5. What advice would you give to someone that is in your situation? 6. What is your hope for your family’s future and the future of PKD? 7. Why do you support the PKD Foundation and its vision that “no one suffers the full effects of PKD?” * 8. Thank you for sharing your story. By sharing your story, you grant us permission to use your story on our website, social media or other outlets to help raise awareness. If this is a problem, please let us know.Please fill out the contact information below and someone from the Marketing Team will be in touch to gather more details and discuss potential media opportunities. Name: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Finished - Thank You!