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Share Your Medicaid Story

Disability Rights New Jersey invites you to be a part of our Story Bank.

The Story Bank is a collection stories that illustrate the vital importance of Medicaid for people with disabilities, older adults, children and families. Through this, we will share our impact as New Jersey’s designated Protection and Advocacy system for people with disabilities.

Tell us about yourself. Your story matters.

For people with disabilities:

How does disability impact your life? How does it empower your life?
Has Disability Rights New Jersey played a role in helping you access services and supports essential to your quality of life and survival?
Have we helped you fight for your rights or correct a wrongful termination of your Medicaid benefits?
Have you benefited from systemic action we have taken to improve lives for all New Jerseyans with disabilities?

For aging adults:

How does Medicaid improve your quality of life?
Does Medicaid help you age in place, in your home or community?
Has Medicaid supported your transition to assisted living or long-term care facilities?

For children and families:

How does Medicaid make a difference in your lives?
Has Medicaid helped you and your family access essential providers and care?
How has Medicaid given your family peace of mind or improved your family’s stability?

Your Story Deserves to be Told

Thank you for entrusting Disability Rights New Jersey with your story and helping spread awareness about disability rights and aging-related issues and people impacted by Medicaid and our legal advocacy. The information, pictures, and videos you provide may be included in our outreach and communications about the work we do and the issues impacting the disability community.

Consent to Share Your Story

Please take a moment to complete our Story Bank submission form. By doing so, you will be giving Disability Rights New Jersey permission to use your image, video recording, written or spoken words, name, and information related to our work with you (if applicable), and your story, as you have provided.

If you would like to speak to someone to explain anything on this form, please reach out to your Disability Rights New Jersey attorney or advocate, or email [email protected] to speak to our communications team. Submission of your story is voluntary.

How Your Story Will Be Used

Authentic representation is of the upmost importance to Disability Rights New Jersey, which is why we strive to share stories and images of real clients and self-advocates of our community to reflect those we serve. Your story or likeness may be used to educate the community and bring awareness of important issues through our social media campaigns, video productions, on our website, and in communications, such as our newsletter, reports, publications, and more. Additional context around your story may be added to enhance our audiences’ understanding, however your story may be edited down to fit the space and need.

How Your Story Can Make a Difference

There is power in sharing your story. Stories give light to representation and create relatability that can uplift another to see themselves, or see things from a new perspective, even if the experience is not shared. Stories educate, impart meaning, and foster empathy to create an emotional connection that can inspire others to act, seek change, take on challenges, and feel motivated to make a difference.

I understand that sharing my story and personal experience is voluntary and I grant permission to Disability Rights New Jersey, also known as Disability Rights NJ and DRNJ, to gather and use my story, images, audio and video recordings, and my written or spoken responses to questions for use in media of any kind, including, but not limited to, video, email, printed materials, website, social media, and other electronic materials. I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties, money, or other compensation arising from or related to the use of the story or likeness. Consent To Share Your Stories, Photos, and Video I Understand and Consent Date* First Name * Last Name * Address Zip Code * (This information is helpful in determining your Congressional District) Congressional Representative Parent/Guardian Parent/Guardian Address Parent/Guardian Zip Code Email * Phone Number Please select which is applicable to your present situation * I am 18 years of age or older and I am competent to give consent in my own name.I am the parent or legal guardian of the named minor or adult. Please select your preference: To protect my privacy and safety, I require the following My full name or the child/adult for whom I serve as legal guardian can be usedOnly my first name or the child/adult for whom I serve as legal guardian can be usedA pseudonym (fictitious name) must be used Tell us your story File Upload (Additional files can be emailed to [email protected]) File Upload (Additional files can be emailed to [email protected]) File Upload (Additional files can be emailed to [email protected])

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