30th Anniversary "Share Your Memories With Us"

1. 30th Anniversary "Share Your Memories With Us"

As we celebrate AA&MDSIF's 30th Anniversary, we invite you to share your memories with us about you and your loved one's experiences facing aplastic anemia, MDS and PNH.

If you are a patient/survivor, tell us your story and share your words of inspiration for others. Let us know how AA&MDSIF has helped you and your family.

If you are a family member, tell us about your experiences -- and about your loved one who has fought a bone marrow failure disease.

If you lost your loved one to aplastic anemia, MDS or PNH, share their story so we can all remember their bravery.

Submissions will be shared by AA&MDSIF through our online and print publications and Web site. Photos are encouraged to illustrate your memories and stories.

Thank you!

Question Title

* 1. The memory I want to share is about... (check all that apply)

My Loved One

How AA&MDSIF Helped Me/Us

Earl J. Goldberg Chapter

Other (please specify)

Question Title

* 2. We have faced the following bone marrow failure disease(s)....(check all that apply)

Aplastic Anemia

MDS (myelodysplastic syndromes)

PNH (paroxysmal nocturnal hemoglobinuria)

Other (please specify)

Question Title

* 3. About You (help us update/verify your contact info)

First Name

Last Name

Address

City

State

Daytime Phone with Area Code

Question Title

* 4. If You Are Not The Patient/Survivor - Who is the Loved One Your Memory/Story is About?

First Name

Last Name

City Where They Last Lived?

State Where They Last Lived?

Question Title

* 5. If Your Memory/Story is About Your Loved One....(complete all that apply)

Date of Birth

Date

Date of Diagnosis

Date

Date of Death(if applicable)

Date

Question Title

* 6. Tell Us Your Memory About Your Experiences
[Stories will be used as part of our My Story Project.)

Question Title

* 7. Share Your Memory of Your Loved One's Experience Fighting Bone Marrow Failure Disease

Question Title

* 8. Tell Us About AA&MDSIF. (How have you/your family benefitted from AA&MDSIF programs and services?)

Question Title

* 9. Why do you think it's important for people to support AA&MDSIF's work (including patient education, advocacy,awareness and research)?

Question Title

* 10. Will You Be Emailing a Photo To Go With Your Memory?
[Send photos as an attached JPG file to mystory@aamds.org.
Rename your photo with your first and last name, then a caption to describe it.
Example: Jim Smith Catching the Biggest Fish Ever After My Diagnosis
We can not use photos that are pasted into an email.]

Yes

Question Title

* 1. The memory I want to share is about... (check all that apply)

Question Title

* 2. We have faced the following bone marrow failure disease(s)....(check all that apply)

Question Title

* 3. About You (help us update/verify your contact info)

Question Title

* 4. If You Are Not The Patient/Survivor - Who is the Loved One Your Memory/Story is About?

Question Title

* 5. If Your Memory/Story is About Your Loved One....(complete all that apply)

Question Title

* 6. Tell Us Your Memory About Your Experiences[Stories will be used as part of our My Story Project.)

Question Title

* 7. Share Your Memory of Your Loved One's Experience Fighting Bone Marrow Failure Disease

Question Title

* 8. Tell Us About AA&MDSIF. (How have you/your family benefitted from AA&MDSIF programs and services?)

Question Title

* 9. Why do you think it's important for people to support AA&MDSIF's work (including patient education, advocacy,awareness and research)?

Question Title

* 6. Tell Us Your Memory About Your Experiences
[Stories will be used as part of our My Story Project.)