TO SHARE YOUR STORY

To create greater global impact with our World Pancreatic Cancer Day Campaign in 2021 we are searching for stories that highlight THE IMPORTANCE OF TIME as it relates to this devastating disease. If you are a patient, caregiver, family member or anyone else who has been impacted by pancreatic cancer, please fill out the form below to share your story.

Tell My Story

"*" indicates required fields

STORY BACKGROUND

Please submit your story in English.

WHAT'S YOUR NAME?

Please tell us your name as story teller.

First Name*

Last Name*

Email*

WHICH WPCC ORGANISATION ARE YOU SUPPORTING?

Please select from the drop down list.

ORGANISATION?*

WHO IS YOUR STORY ABOUT?

Please share the name of a patient, caregiver, family member, friend, or healthcare professional.

My Story Is About*

WHEN DOES YOUR STORY TAKE PLACE?

During what timeframe?

FROM ➔

➔ TO

If the time frame is important for your story, please specify here. If not applicable, please leave blank.

HOW WAS PANCREATIC CANCER DISCOVERED?

It was discovered...

THE IMPACT OF TIME

WHAT CAN YOU SHARE ABOUT THE VALUE OF TIME RELATED TO PANCREATIC CANCER? FOR EXAMPLE...

HOW HAS YOUR OUTLOOK ON TIME CHANGED BECAUSE OF PANCREATIC CANCER?

HOW MUCH OF A ROLE DID EARLY DETECTION PLAY IN YOUR STORY?

WE OFTEN THINK OF TIME AS A “GIFT” - HOW DOES THE GIFT OF TIME RELATE TO YOUR STORY?

Write here..

YOUR UNIQUE STORY

EVERYONE’S STORY IS PRECIOUS, SO PLEASE FEEL FREE TOSHARE ANYTHING ELSE YOU WOULD LIKE.

Tell your story...

UPLOAD PHOTOS OR A VIDEO

PHOTO

Accepted file types: jpg, jpeg, png, gif.

This will be the featured image for your story. However, uploading a photo is not required.

VIDEO

Accepted file types: mov, mp4, wmv, Max. file size: 50 MB.

Consent*

WPCC has my permission to use this story, photo and/or video content.*

Please check box on the left to confirm that WPCC may edit and share your story on the WPCC website, social media channels and other digital media.
You may review our privacy policy here.

Your story will be shared during the WPCD 2021 Campaign starting Nov. 1st.

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Phone

This field is for validation purposes and should be left unchanged.

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