National Nurses United

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SUBMIT YOUR HEALTHCARE STORY

Are you getting the healthcare you need, when you need it, at a price you can afford?

Nearly 48 million Americans have no health insurance at all and nearly 50 million more are under insured with high deductibles and co-pays discouraging them from seeking the care they need in the preventative stages. We've created this form to collect your stories, which may be used on our websites, in the news, to educate the public, and/or at legislative hearings. By completing this form, you are granting CNA/NNU the right to publish your healthcare stories.

Email Address: *

First Name:

Last Name:

City:

State:

Zip code: *

Phone Number: *

Title of Your Story: *

Health Problems:

Image *

Are you a CNA/NNU nurse member?

  N/A
  Yes
  No

Healthcare Status: *

My Story:

Tell Us Your Story: *

Word Verification: *

Type the words you see below into the Word Verification box.

CAPTCHA Word Verification

Instructions

Please enter the words you see in the box, in order and separated by a space. This helps prevent automated programs from abusing this service.

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Visually impaired users can click the audio button to hear a set of digits that can be entered instead of the visual challenge.

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