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SUBMIT

YOUR STORY
for a

chance to

be featured in BITTEN

Lyme is a sometime chronic illness that can greatly impact the lives of those who have it. Bitten is a social inquiry exploring how living with Lyme or a Lyme-like Disease (LLDs) can affect the various aspects of one’s life from the social relationships to the workplace. While Bitten is guided by research, it will feature stories from those most affected. We hope to gather and share narratives that illustrate the trends found from the survey.

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We want to hear from you, the Lyme community, about how Lyme or a Lyme-like Disease has impacted your life. We ask that submissions are limited to roughly one typed page and focus on one or some of the following:

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  • How your illness has affected your relationships with family and friends

  • How you share your illness and/or medical struggles with your family and friends

  • How your illness has affected your ability to work and your relationships in the workplace

  • Your experiences interacting with the medical profession (diagnosis, treatment, specialized doctors and/or alternative treatment)

  • How your access to health insurance and your financial status have affected your ability to receive treatment

  • If you are living with a spouse or domestic partner, how has that affected your ability to manage your illness (treatment, financial resources, emotional support).

Please read the terms and conditions below regarding the terms and conditions of your story submission before submitting a story. Submission of a story indicates that these terms have been read and that you consent. Please use the best grammar and punctuation possible and tell your story as earnestly as you can. Thank you for taking the time to contribute to Bitten!

TERMS AND CONDITIONS

CONSENT FORM​

 

I understand that Caitlin Shea, Gretchen Rossman, and Dale Jones (the Authors) are preparing, writing, and will publish a work on the subject of Lyme Disease, which is currently titled Bitten (the Work).

 

In order to assist the Authors in the preparation of the Work, I have agreed to submit a statement and potentially be interviewed and to provide information and other materials to be used in connection with the Work, including my personal experiences, remarks, and recollections as well as any photographs and documents that I may choose to give to the Author (the Interview Materials).

 

I hereby grant and assign to the Authors and their licensees, successors, and assign the following rights in connection with the Interview Materials for use as part of the Work or any derivative material including but not limited to advertising, packaging, or promotional materials for the Work, presentations, in any and all editions, versions, and media, in perpetuity and throughout the world.

 

1. I acknowledge that the statements and words submitted are my own and do not belong to others and that I hereby take legal and financial responsibility if the statements I submit misrepresent and appropriate of already published and copyright materials that do not belong to me.

 

2. The right to quote, paraphrase, and edit for clarity all or any portion of the Interview Materials, and to generally use and publish the Interview Materials, including my experiences, recollections, incidents, remarks, dialogue, actions, and information, as well as any photographs and documents that I may give to the Authors.

 

3. The right to use my name, image, and biographical data unless otherwise stated prior to my interview or text submission.

 

4. I understand that I may be contacted to expand upon, clarify, or add additional context to the work I submit. I hereby consent to the same terms outlined in this form with regard to any continuing dialogues or submission unless otherwise stated prior to responding.

 

5. The right to develop, produce, distribute, advertise, promote, or otherwise exploit the Work as a book or any other Work in any manner that the Authors assigns deems appropriate. I understand and acknowledge that the Authors or whomever they assign will be the sole owner of all copyright and other rights in and to the Work. In order to enable the Authors to develop the Work in any manner that the Authors may deem best, I hereby release and discharge the Authors and their licensees, successors, and assigns, from any and all financial, legal, and other claims, demands, or causes of action that I may have against them by reason of anything contained in the Work, or any of the above uses, including any claims based on the right of privacy, the right of publicity, copyright, libel, defamation, or any other right. I acknowledge and agree that I am not entitled to receive any form of payment from the Authors and/or their licensees, successors, and assigns.

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6. I acknowledge that I may not be published in the Work or any other derivative materials. 

 

Agreed and confirmed (consent to be considered granted upon submission of a story through either the form above or if emailed directly to bitten.contact@gmail.com)

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