Share Your Stories and Caregiving Tips

I authorize BrightFocus Foundation to use the materials identified below for purposes of sharing information. Materials submitted can be used by BrightFocus in its publications, presentations, website, Facebook and other social media vehicles. These materials will help increase awareness of Alzheimer's, macular degeneration, and glaucoma.

After your information is reviewed for appropriate content, it will be posted on the website.

Title

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Email *

Choose a Program *

Alzheimer's Disease

Macular Degeneration

Glaucoma

Upload Photo/Image 1

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

Upload Photo/Image 2

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

Video Uploads

Please provide your YouTube link.

Please Confirm *

Yes, the above statements are accurate

By checking the box below you are giving the BrightFocus Foundation permission to post the information on our website and use it in informational materials, and acknowledging that you have obtained signed consent forms from all individuals who participated in the photograph(s), audio recording(s), video(s), or written material(s). After your information is reviewed for appropriate content, it will be promptly posted.

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Share Your Stories and Caregiving Tips

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