Please Share Your Polio Story

You can use this form to write and share your polio story online with the Polio Australia Team, fellow “We’re Still Here!” Campaigners, and the community.

Please complete all fields

    Your Name

    Your Email (not published)

    Title of Your Polio Story

    Choose a Category for Your Polio Story (you may select more than one category)

    I am a polio survivorI am someone's brotherI am someone's colleagueI am someone's cousinI am someone's customerI am someone's daughterI am someone's fatherI am someone's friendI am someone's granddaughterI am someone's grandsonI am someone's husbandI am someone's motherI am someone's partnerI am someone's patientI am someone's sisterI am someone's sonI am someone's wife

    Please Type Your Polio Story Here (contributions of no more than 500 words are preferred)

    If you wish, you can upload up to 3 photos to accompany your story - accepted file types are gif, png, jpg, jpeg, pdf
    (maximum size per file is 1MB)

    Thank you for sharing your polio story. To now send your story to Polio Australia, please click the button below.

    Thank you very much for sharing your polio story for publication on this website. If you have any difficulty completing this form, please contact us.

    Polio Australia aims to publish all contributions but reserves the right not to publish every story or photo received, and may abbreviate or edit the content of stories for reasons of space, readability or otherwise.