Permission for us to share your story

Thank you for tell us about your PH experiences. Please complete the form below to confirm you give permission for us to share your story.

If you have any questions, or you’d like to withdraw or amend your consent at any time, please email media@phauk.org.

Permission to share my story

Your name(Required)

Are you happy for your name to appear with your story?(Required)

Yes, that’s fine

No, I would like my name changing

Please confirm you are happy for your story, or parts of it, to be shared in the following ways (mark all that apply):(Required)

On one or all of the PHA UK websites

In printed materials published by the PHA UK, including Emphasis

On the PHA UK social media channels

As part of press / media releases to raise awareness of PH

In presentations / at events organised or attended by the PHA UK

If you have submitted photos to be used with your story, please check this box to confirm you are happy for these to be used in the ways identified above

I’m happy

Please add comments if you wish

Please enter today's date as confirmation of all of the above(Required)