Submit A Legacy StoryName of Individual Submitting Story:* First Last Phone:**You will be contacted by our community education department via phone or email to complete an authorization form and release for your story to be used on our website and social media pages. Your phone number and email will not be used for other purposes beyond contacting you for this story unless you opt-in to our newsletters.Email:* Opt-In Opt-in to Quarterly Wings Newsletter Opt-in to Annual Email UpdateWho is the legacy story about?*(First and Last Name)Legacy Story:*You may write a short version of your story here and submit an attachment via email to hsimedia@hospice.org. Use Legacy Story in the subject line.Submit a photo to upload:FileTitleCaptionPhoto & Name Authorization* By checking the box, you authorize and release these names, the story and the submitted photo to be used. Proceed to date and signature portion.Date* Date Format: MM slash DD slash YYYY Signature*Left-click and hold down on your mouse to sign.How did you hear about the Legacy Story?* Personal experience Hospice volunteer Social Media Chamber of Commerce Family member or friend Newsletter Exploring the website OtherCheck all that apply.
