GOOD Ad Interest Form

Please fill out this form to express interest to have you or your loved one's story shared in the form of Social Media, Good Ad (newspaper PSA), traditional media or any other purposes to further LifeShare's mission.

By submitting this form, you are agreeing to allow LifeShare to share the story you described below to further the organization's mission.

PLEASE NOTE: Due to the overwhelming response, we cannot guarantee any particular story will be featured in any way -- nor can we provide you physical or digital copies when a person is featured.

Question Title

* I am a...

Organ Recipient

Tissue or Cornea Recipient

Living Donor

Organ Donor Family

Waitlist Candidate (organ or tissue)