Skip to content

Basic Information

I am a...

Chronic Disease Information

Do you or someone you know have experience with...

Do you agree to receive email updates and notifications from the Chronic Disease Coalition?
By completing this form, you agree that the CDC can share your story with lawmakers, online, in-person and in educational and promotional materials. We tell patient stories to advance our mission of patient-centered care. We do not sell or give patient contact information to any other company, organization or individual without your permission. Visit our Privacy Policy to learn more about how we use your data.