PAD Awareness Month – Share Your PAD Success Story

We believe that sharing your experiences with Peripheral Artery Disease (PAD) can make a real difference. It’s not just about raising awareness; it’s about connecting with others, offering hope, and showing the power of early detection.

Every Story Matters

Whether you’re a patient, a caregiver, or a healthcare professional, your unique perspective on PAD is valuable. Your story could inspire someone to seek help sooner, encourage a loved one to get screened, or even save a life.

Share & Inspire

As a thank you for sharing your story, we’ll send you a special PAD Awareness t-shirt. Wear it proudly, snap a photo, and share it on social media to help us spread the word.

Together, We Can Make a Difference

This PAD Awareness Month, let’s use the power of storytelling to create a lasting impact. Your voice matters.

Please enable JavaScript in your browser to complete this form.

Ready to share your story? *

Do you have a story about how early detection of PAD changed someone's life for the better? We'd love to hear it! Please remember to protect patient privacy and avoid sharing any identifiable information.

PAD Awareness T-Shirt - Select Style *

• I Save Limbs. What's Your Superpower?
• Changing Lives One Limb At A Time
• Keep Calm And Save A Leg

PAD Awareness T-Shirt - Select Gender *FemaleMale

PAD Awareness T-Shirt - Select Size *SmallMediumLargeX-LargeXX-Large

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Signature - Release Permission *

Clear Signature

Your signature will grant us permission to utilize the success stories you submit in our marketing efforts, including campaigns, social media, and various promotional activities. Your valuable contribution will help raise awareness and inspire others within the medical community. Thank you for your participation and support.

Social Media Tags - Provide Your Handles (OPTIONAL)

By providing your social media handle/avatar above, you are giving us permission to tag you if we decide to promote your shared story. We will not tag you in any post that is unrelated to your specific success story. If you do not wish to be tagged, please do not fill out this field.

Send My T-Shirt!