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HC DrugFree Blog: Share Your Story
Share Your Story
Thank you for your willingness to share your story. Your experiences can help educate, inspire, and support others in Howard County.
1.
Please share your story. You do not need to include names or any identifying information. You may attach a file here or respond below in Q2.
Choose File
No file chosen
2.
If you didn't attach a file to Q1 and you prefer, you may write your story in this comment box.
*
3.
What topic(s) does your story relate to? (Select all that apply)
(Required.)
Youth substance use prevention
The impact of behavioral health disorders
Education on prevention, treatment, recovery, and wellness
The dangers of substance misuse and medication abuse
Other (please specify)
*
4.
Would you be willing to be contacted for follow-up questions or to provide additional insight?
(Required.)
Yes
No
5.
Personal Information (Optional): Providing your contact information is optional, but it will allow us to follow up with you if needed.
Full name:
6.
Email address:
7.
Phone number:
8.
Preferred method of contact (select all that apply):
Email
Phone Call
Text
*
9.
Age
(Required.)
Under 12
12-14
15-17
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to reply
*
10.
Do you currently live in Howard County?
(Required.)
Yes
No
11.
If yes above, what HoCo community do you live in (Optional)?
Clarksville
Columbia
Cooksville
Elkridge
Ellicott City
Fulton
Glenelg
Glenwood
Highland
Ilchester
Jessup
Laurel
Savage
Scaggsville
West Friendship
Woodbine
Woodstock
Don't live in Howard County
Other (please specify)
12.
Thank you for sharing your story and helping us educate and support our community. If you have any questions, please contact us at admin@hcdrugfree.org.
