Share Your Story

Every story is unique, and we hope your story can help inspire others and increase awareness of kidney disease in Australia.

Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Kidney Health Australia and its affiliates and agents, to use images and likeness and/or any interview statements in its fundraising appeals, publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to:

a) Permission to interview, film, photograph, tape, or otherwise make a videoand/or record voices;
b) Permission to use quotes from the interview(s) (or excerpts of such quotes), film, photograph(s), tape(s) and/or recordings, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for fundraising, educational and awareness.

By consenting to this policy, I agree that: The activity has been explained to me, and all of my questions have been answered to my satisfaction, I have read all of the information contained in this form in relation to the activity, I have been informed that participation in the activity is not mandatory and I give my consent freely.