Submit your diary

Please fill out the form below to upload your symptom diary. 

Add your first name (or the name you wish to appear on the site):

Add your age:

Add your underlying medical condition:

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Add your country of residence:

Add your email address (this will not be published):

Upload a picture of your diary

Please note: Submitting your diary does not guarantee publication. We may contact you via email if we want to know more information, and we may send you emails from time to time, no more than one email every couple of months. You will be able to unsubscribe from our emails as per GDPR. We will not use your email address for any other purpose or provide it to anyone else. See the site Terms of Use for more information.

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