Submit Your Story

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Submit Your Story

Ready to be brave and speak out?

Share your story, and we will post it on www.realnotrare.com. It will be shared on social media as well.

We are stronger and louder together! These real stories appeal to our audiences senses and emotions, not only drawing attention to our cause, but also leaving an impact on those around the world. In doing so, people are forced to reaffirm or rethink their views, and many are drawn to then help and spread the word. Telling your story also lets others in our situation know they are not alone, and provides them a community to reach out to. We already have over 100,000 viewers per month on the website alone. Thousands more on social media! Without your continued stories, this would not be possible.

Help keep Real Not Rare going, and speak out!

Thank you. ~ Team "Real, Not Rare"

First Name *

Last Name *

Email (this will not be posted) *

Optional - Phone Number (for us to contact you if we have questions. This will not be posted)

Which brand(s) of vaccine did you get? *

What was the date(s) of your dose(s)? *

Optional - Vaccine lot number(s):

Where are you from? *

How old were you when you received your covid vaccine?

What was your life like before you got the vaccine? *

Optional: Would you like to share your reasons for getting the covid vaccine?

What was your reaction, symptoms & timeline? Tell us your story: *

Optional - What is your life like now, after getting the vaccine?

Optional - Share your experience with any medical care and tests received:

Optional - Have you received any diagnoses? If so, how did you receive it or what test led to the diagnosis?

Optional - Where was your reaction reported (ie VAERS, CAERS, CDC, Yellowcard, etc) and what was the response?

Optional - Is there anything that has helped?

Optional - Is there anything that has made things worse?

Optional - Have your symptoms improved?

Optional - Have you had covid before? When? What was your experience if so?

What do you wish others knew, or what else would you like to share? *

Optional - Enter a link to your fundraiser like GoFundMe or LifeFunder

I verify that the statements made in the above submission are true and correct to the best of my knowledge, information and belief.

Required

I verify that I am either the individual whose experience is described in the above submission or said individual's parent/legal guardian.

Required

I agree to allow Real Not Rare to share my story publicly on their website and social media platforms. I understand that my story will be posted publicly, and Real Not Rare can not prevent anyone else from sharing it once it is made public.

Required

I agree to notify Real Not Rare immediately if I should discover mistakes in my story, in order to help keep the integrity of the website.

Required

IMPORTANT - PLEASE READ - We cannot post your story until you email us a copy of your headshot (a picture of you) to vaxlonghaulers@gmail.com. Please do so after submitting this form. *

I understand that I must upload a headshot to vaxlonghaulers@gmail.com in order for my story to be shared.

Required

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