Once you have submitted this form, Alzheimer's Society will review and publish your story in accordance with our social media community guidelines. Only your first name, story and image (if provided) will then appear on the story wall. You may be identifiable from a combination of your name, details in your story and image.
We will never share your contact details externally and will always let you know how we use your story. Read our privacy statement to find out how we use personal information.
You can also ask us to delete this information at any time by calling Supporter Care on 0330 333 0804 or email [email protected]