Share Your Story Form - Synergy Radiology Associates

Please tell us about your experience.

We invite you to share your experience about how your radiologist changed your life. By sharing your personal story, you can help others connect with the right radiologist. Your experience can make a difference in the lives of others by helping them take charge of their healthcare during the diagnosis stage of their journey — undeniably one of the most critical moments in their lives and one that typically involves a radiologist.

Your story could be featured on Synergy’s Patient Stories Page!

Name*

Email*

Phone

Your Story Title*

Your Story*

I agree to allow Synergy to share my story
Sharing your story and personal details is voluntary. Please review the following terms and conditions before sharing your story. By sharing your story (e.g., your personal experience, photo, radiology procedure, diagnosis and/or treatment, etc.), you are indicating that you have read, understand and agree to these terms and conditions. Specifically, you, understand, agree that Synergy Radiology Associates shall have the right, where permitted by law, to print, publish, distribute, and use in any media now known or hereafter developed, in perpetuity and throughout the world, without limitation, your entry, name, portrait, picture, voice, likeness, image, statements about the campaign, and biographical information for publicity, marketing, and promotional purposes, without any further compensation, notice, review, or consent. You further agree that Synergy shall have the right to remove, edit for length, clarity and style, move or delete any content at any time should it see fit.

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