Your Story is Unique

Your Story is Important

We know that living with a bleeding disorder brings unique daily challenges. Sharing your story helps people to understand what it is like to live with a difficult life-long condition. Sharing your story will help bring awareness to others about bleeding disorders and will help us to advocate for our needs.

Please share some thoughts in the spaces below. This form is just a guide to help you, please feel free to share whatever you think is important.

All personal information will be kept confidential and your contact information will never be shared without your consent.

I am... *
Choose any description that applies to you. You can choose more than one.
Address *
Phone *
How has your life been affected by a bleeding disorder?