See Yourself in a Book by J.C. Hannigan!
If you are interested in potentially having your rare conditions and/or rare medical experiences featured, please fill out this form. I figured this might be a cool way for us to spread awareness of our rare diseases, and give characters with our conditions and experiences more representation.

Please note:

* You MUST be over the age of 18*, or have your parent fill out the form.

* There will be no financial compensation, and I reserve the right to take creative liberties with all submissions.

*** I cannot guaranteed when the character or stories will be used, but this collection of information will be saved for future use in all of my books.
Sign in to Google to save your progress. Learn more
Email *
Name and D.O.B.
You'll receive a shout out at the beginning of the book for helping me bring more rare characters to my pages!
What are your rare disabilities, invisible illnesses, or other health conditions?
Describe a key experience that you have had with your medical condition that want your character to experience too.
If you're over the age of 50, what was life like growing up with your disabilities and conditions?
Are there any other details about your character your wish to include?
Example: character traits, pets, family, genealogy.
Name Your Character!
* I understand that by filling out this form with my information and by signing it, I am giving J.C. Hannigan the right to use the information I provide for future use in her stories.
Please initial.
* I understand by filling this out and signing it, I am aware I will not receive financial compensation if my character appears in a book.
Please initial.
* I understand that once this form is submitted, permission cannot be rescinded.
Please initial.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms