Topical Steroid Withdrawal Advocacy Model Interest Sign-Up
Hello!

Thank you for your interest in being a part of an art exhibit featuring Topical Steroid Withdrawal warriors. We are gathering an interest list of 20-30 TSW patients, of all ages, ethnic backgrounds, race, and case progression. The mission of our exhibit is to help raise awareness for Topical Steroid Addiction, and to help assist ITSAN with their advocacy efforts. Jeremy Cowart has agreed to pioneer with us in this project by offering us a one day shoot at his studio in Nashville, Tennessee on Friday, March 31st. The session for each model will be about 10 minutes. He has graciously offered to do this project for free, which is huge as he is considered a celebrity photographer. You can see examples of his projects and past clients here: https://cowart.io/

By filling out this form, you agree to be contacted regarding this photoshoot, and consent to having images shared online, across social media, and various internet platforms by Jeremy Cowart, Jessica Morrison, ITSAN, and any other third party companies we may choose to partner with to help raise awareness. There is no compensation available. The information shared below will be confidential and not shared with a third party without a follow-up requesting permission. (i.e. Should we partner with an organization that would like to contact you, we will ask you first if you would like an introduction.) 

As this develops, we hope to secure a hotel for a discounted booking rate to make selecting accommodations more affordable. Any expenses incurred for food, travel, lodging, etc. are at the discretion of the model and we cannot offer reimbursement. We are exploring the idea of making this a TSW retreat (to also make the most of your trip), but our main focus at this time is creating the art. If you have an interest in helping us make this a retreat for TSW patients, please let us know.

Our hope is to have Jeremy's work featured in a gallery, partner with various organizations/friendly skin-related businesses and non-profits, to have an exhibit that showcases what we as TSW patients experience. It is our hope that this exhibit will be picked up in the news and put pressure on pharmaceutical companies to conduct more research on addiction. It is our hope that this creates greater and more effective conversations in the dermatology community. Your support in sharing Jeremy's work online will help reach a wider audience, and aid in awareness efforts.

Photoshoot Date: Friday, March 31, 2023

If we reach an interest list beyond 30 applicants, you will be put on a waitlist. If you register and decide to cancel, please let us know ASAP so that we can ensure we have enough models. 

If you have any questions about this project, please feel free to contact Jessica Morrison (maiden name is Casner) at: jessicacasner@gmail.com or at 317-679-3223. Please feel free to text, as the voicemail box fills up quickly. 

You can also connect with her at: 
- facebook.com/jessica.casner.77
- instagram.com/jessicacasner
- jessicacasner.com

Thank you again for your interest in being a part of this exhibit. We appreciate your prayers, support, and sharing this with people you think may find it encouraging in their journey. Your life is valuable. Your suffering has a purpose, and you are stronger than you know. We are here for you, advocating with you, and fighting to make this chapter an epic victory. 

Grace & Peace
Jessica Morrison

Psalm 23
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Email *
First & Last Name *
Mobile Phone Number  *
Are you a parent filling this out on behalf of your child? *
Child's Name 
Full Mailing Address  *
Age of TSW Patient *
How long have you been in Topical Steroid Withdrawal? (years, months) *
What is your ethnic background?  *
What is your race? *
How comfortable do you feel in front of a camera? (1= terrified, 5=very comfortable) *
By signing my name below, I consent to have the images taken by Jeremy Cowart be shared on social media, featured in a gallery, and potentially used by third party organizations to help raise advocacy and awareness efforts for Topical Steroid Withdrawal. I understand there is no compensation or reimbursement offered at this time, and that by participating in this photoshoot I agree to travel to Nashville, Tennessee at my own expense. (sign name) (include both adult and child names if applicable) *
Do you have an interest in participating in a retreat if we were to put one together during your time in Nashville? *
In traveling to Nashville for the photoshoot, will you be securing overnight accommodations at a hotel or AirBnB?  *
Please share any relevant information you think may be helpful as we consider models for this project.
Do you have any questions or ideas we should consider?
A copy of your responses will be emailed to the address you provided.
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