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Your story matters. If you or a loved one has been affected by asbestos, please tell us about your experiences and read stories of others like you. You are not alone.

Your comments, thoughts and opinions are welcome; however ADAO does reserve the right to delete inappropriate or abusive comments. By sharing your story on this site, you understand that the words you write are viewable by the public. Your comments are your own and ADAO is not responsible for any harm caused by hateful speech, libelous statements, and illegal activities linked to your writing.

CONTACT INFORMATION FOR PERSON SUBMITTING STORY
I am a:	Select Below Patient Caregiver Family Member Friend of a Patient Widow/Widower Other
First name:
Last name:
Address:
City:
State:	[- Select a State -] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas US Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
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Phone:
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POSTED VICTIM'S STORY INFORMATION (For a person exposed, patient diagnosed with asbestos- related disease or descendent)
Name :
Date of Birth :
Date of Diagnosis :
Diagnosis:	Select Below Asbestosis Pleural Plaques/Scaring Mesothelioma Lung Cancer with documented asbestos exposure Other Cancers with documented asbestos exposure
Date of Death (If applicable):
Treatment (optional):
State :	[- Select a State -] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas US Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
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	(No spaces in file name and only .jpg, .jpeg and .gif)
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.