Share Your Story

A personal story can be a powerful tool. Whether you called about yourself, a family member, a friend, or one of your patients. Share your story to encourage others to use our service, spread the word about poison prevention and help us improve our service. Your story does not have to be written perfectly. Your name and your story will not be shared with anyone without your explicit consent.

Name*
First Last
Email*
Zip Code*
County*
Date You Called (if known)
Date Format: MM slash DD slash YYYY
You Called on Behalf of
How did you hear about the Georgia Poison Center?
Your Story*
May we bring your story to a wider audience?*
- Yes, and you may use my full name
- Yes, but you may use my first name only
- Yes, but I would like to remain annymous
- No, you may not share my story
You may contact me to follow-up on this experience*
- Yes
- No
Phone*
Comments
This field is for validation purposes and should be left unchanged.

Share Your Story

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