First Name*
Last Name*
Email*
City
State
How did you find out about AARDA?
What is your autoimmune story?
How has AARDA helped you?
Upload a picture of the patient?

* Required

We will not share any information publicly without your consent.
I authorize AARDA to use the following when using my submitted Impact Story: My Name as enteredMy InitialsMy CityMy StateMy Submitted Photo

By submitting your story and clicking the Submit button you grant the American Autoimmune Related Diseases Association (AARDA) permission to use your story, name, city/state, and photo (if you provided) as part of our efforts to increase autoimmune disease advocacy and awareness efforts. Please keep in mind we may not use all stories submitted, but appreciate you sharing your story. We reserve the right to edit or summarize your story. I understand the terms as described above.