Rare Stories

Thank you for sharing your unique story with us as part of Rare Disease Week on Capitol Hill. The deadline for submissions is February 11, 2018.

Name*
Please upload a photo to share with your Members of Congress
Email*
Home Address*
Street Address Line 2 City State ZIP Code
Phone*
Organization Affilation
Website

Please list the website of your patient group or your personal website.
Rare Disease*
Relationship to Person with the Disease*
About Disease (Select One)
Advocacy Issue (Select One)
Personal Statement
Please write a statement about how rare disease has affected your life and what you would like your U.S. Representative and Senators to do on behalf of the rare disease community.
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