Share your story
Real life stories are important to us as they show the reality of life with macular disease - something that is not widely known.
This form is to gather basic details about how we may use your story and/or image. Please note that we will endeavour to contact you before using your story or image to make sure you still agree, but if you no longer want your story to be on file and potentially be used please do let us know.
A parent or guardian must complete this if the person in the story is under 16.