I am a: SELECT BELOWPatientCaregiverFamily MemberFriend of A PatientWidow / WidowerOther
State: SELECT BELOWAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyoming
Zip / Postal Code:
POSTED VICTIM’S STORY INFORMATION (For a person exposed, patient diagnosed with
asbestos- related disease or descendent)
Date of Birth:
Date of Diagnosis:
Diagnosis: ---AsbestosisPleural Plaques/ScarringMesotheliomaLung Cancer With Documented Asbestos ExposureOther Cancers With Documented Asbestos Exposure
Date of Death:
Photo: Submitting a photo is a requirement in order for ADAO to consider your story for a dedication and/or in other communication or promotional materials.
(Photo size must be less than 100MB–otherwise, you will see an error screen instead of posting your material. Also, please do not put spaces in the filename, and only .jpg, .jpeg, png and .gif images are allowed.)
How has asbestos changed your life?
(300 word count maximum):
By submitting my story, I agree that ADAO may use
my story and photo in educational and advocacy materials.
ADAO will not sell, trade, or rent your personally identifiable information to third parties.
Please enter the character on the right to show us that you are a human being and not a spam bot:
You are not alone. Join our ADAO “Share Your Story” community about how you or your loved one has been affected by an asbestos-caused disease such as mesothelioma, lung cancer, and asbestosis.
"Success is only a string of failures held together by endurance!" #Quote
ADAO Share Your Story: “If I Should Fall Behind” – Charles’ Story bit.ly/1ipSVyZ#Asbest… #Mesothelioma #BanAsbestosNow
ADAO See for Yourself PHOTO: #Asbestos fibers in appliance wiring by @asbestorama #TSCA #Mesothelioma pic.twitter.com/8odF8IPaHN
PSA VIDEO: #Asbestos: The Killer You Can't See - @YouTube bit.ly/2rjOg12 #asbestos #mesothelioma @Culture_Shift
@EPA @EPAScottPruitt is Turning a Blind Eye on Deadly #Asbestos Legacy in Homes, Schools, Workplaces, and Our Envir… twitter.com/i/web/status/1…