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Your stories and questions here, please!

Name *

Email *

Subject *

What's on your mind? *

Is it OK if we share this (or an excerpt, or a summary) on the show or in our newsletter? *

You bet, and you can use my full name
Yes, but please just use my first name (and age and geography)
Yes, but no names or other identifying info, please
Actually, no-- this is just a tip I want you to have, but don't share it at all.

Anything else we should know about whatever privacy you need, and how to maintain it?

OK, awesome. If that's cool, then: How old are you?

... and where do you live?

(This could be your city, your state, etc.—depending on what it takes to maintain a bit of privacy for you.)

Phone number, if you're OK with us following up that way?

If we want to report more on this story, would you be willing to share documentation? (Stuff like medical bills, insurance statements, communication from providers/insurance?) *

Yep, you bet.
Maybe-- tell me more about how you keep that secure
Geez, no.

Got a voice memo, or a medical bill, or another document you'd like to upload to us?

Click or drag files to this area to upload. You can upload up to 3 files.

This form accepts audio files (.mp3, .mp4) and documents (.doc, .xls, .pdf)

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