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Tell Us Your Story

Statistics do not tell the human side of what an exposure to an environmental chemical can mean to a child. By sharing your child’s experience, you will help CHEC personalize and strengthen its message.
Name:

Please provide contact information.

You may contact me via: (check all that apply)
mail:

  Address:
  City:
  Zip:
  State:


phone:

 
  Phone:


email:

 
  Email:
   
I am willing to share my story: With parents
On the CHEC website/CHEC print material
   
Yes
No
I am willing to be contacted by others regarding my story (i.e. advocacy groups, media, etc.)
   

When writing, please include the following information:

  • What is your child’s illness
  • What has the impact of that illness been on him/her & family
  • What do you suspect/know about environmental links to this illness
  • What actions have you taken to address the problem
  • How has CHEC helped you (providing resources, support, contacts)

Disease:
Exposure: *suspected or confirmed

Tell us your story: