Share your story

Thank you for volunteering to share your story with us. Stories like yours serve a vital role in raising awareness of the human impact of spinal cord injury.

Please note that by providing the information below, you agree to Spinal Research sharing your story on our website, social media channels, newsletter and possibly in printed materials. We may not be able to share every story sent to us.

Your details

First Name

Last Name

Phone

Date of birth

Your connection to Spinal Research

Connection to Spinal Research

Injury level

Injury severity

How injury occurred

Year injured

Mobility impairment

Your story

Please tell us your story

You can write about your interests, hobbies, life before your injury, how the injury occurred, and the impact the injury has had on you and your family.

If you have any photos you would like to share alongside your story, please upload them here.

What areas of function are you most interested in improving?

Bladder and bowel	Blood pressure regulation	Breathing
Hand and arm	Leg	Pain management
Reduced spasticity	Sexual function	Temperature regulation
Other

How would improving these functionalities help your day to day life?

Do you have a message for the spinal cord injury community?

Are you interested in fundraising for Spinal Research?

YesNo

Are you interested in finding out about becoming a Spinal Research Ambassador?

YesNo

Communication preferences

We would love to keep you up to date with all the latest Spinal Research news and information. If you'd like to receive our updates please let us know how you'd prefer to receive them:

Phone

Text message

By ticking the preference boxes and submitting this form, you are agreeing to join our contact lists. We'll only send you information related to Spinal Research. Your privacy is important to us and we process your personal data in accordance with the UK GDPR and our Privacy Policy. You can unsubscribe at any time. For more information about our privacy practices, please visit our website.

Contact Information