Did you know you can share your stories anonymously or have it published only with your first name? By sharing your experience, you become a catalyst for change, providing a unique perspective that policymakers and reform advocates need to understand the real-life implications of their decisions. Your story has the potential to influence meaningful reform, creating proactive policies, programs, and systems for children and families exposed to substance abuse, abuse, and neglect.

Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Email *

Your email will not be shared.

I am ____ *

the child

a sibling

a parent

a relative

a friend

a teacher

a child care provider

a social worker

a family law professional

a court advocate

other

If 'other', how would you describe your role? *

Issues at play: *

Domestic Violence / Abuse / Neglect

Substance Abuse (Alcohol/Drugs)

Financial Struggles

At Risk for Homelessness

Not Applicable

List courts, institutions, programs, organizations, or public authorities involved: *

What state? *

If not applicable, select no involvement.

What County? *

What year was the decision made? *

Tell us your story *

If you could turn back time, what would you want the parents, resources, community, or court professionals to do differently or consider? *

What programs, policies, or arrangements worked well for the child(ren) or family? *

Do you understand that by checking the consent checkbox, you will give permission for us to be able to collect quotes from your story to use internally and/or in campaigns without any identifiable details. Signing this form does not give us permission to share anything publicly with identifiable details. *

Yes

Would you like to keep in touch for further involvement?* E.g., Working together to share your story publicly and/or participating in other activities. *

Yes

I certify that I am not a minor, and I am free and able of giving my own consent. *

Yes

I declare under penalty of perjury that the foregoing written story I am submitting is true and correct. *

In order for us to share written testimonials, this legal DECLARATION OF FACT must be completed by you. This ensures your submission is truthful and factual.

I agree to the above declaration.

I disagree to the above declaration.

I hereby release this website and its owners from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss or damage due to my submitted testimony. *

I agree to the above declaration.

I disagree to the above declaration.

Do we have your consent to contact you and use your contact details when it's time to submit witness slips for the legislative bill? *

Yes

Maybe (We will reach out to you when it's time)

Do we have your consent to add you to our electronic mailing list? *

Yes

Do you consent to your story being shared publicly? *

Yes and you can use my first name.

Yes, Anonymously.

No.

I assign rights of the submission to the website so the website can use it. *

I agree to the above declaration.

I disagree to the above declaration.

Thank you for sharing your story!

Unity for Children

#UnityforChildren | ILLINOIS

Disclosure: Unity for Children is a community-driven organization dedicated to systemic advocacy, public education, and collaborative efforts aimed at improving policies and programs that support child well-being. We do not provide legal representation, case-specific advice, or services related to individual court proceedings. Our focus is on promoting broad, systemic change rather than intervening in individual legal matters. Community members involved in legal disputes are strongly encouraged to seek guidance and representation from qualified attorneys or licensed professionals. The information provided by Unity for Children is for educational and informational purposes only and should not be considered legal, medical, or therapeutic advice.