Share Your Story

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Share Your Story

We want to hear from you! Tell us your story and how Ranken Jordan impacted your life. We want to hear from kids, siblings, parents, volunteers – everyone! Did you spend time at “the house” on Ladue Road? Did you recover at the hospital in Maryland Heights? Tell us about your experience and how you are feeling today. Share these moments with us so we can understand our history and shape our future. Photos are encouraged!

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By clicking "I agree" (below), you consent to be:

  • Photographed
  • Videotaped
  • Interviewed
  • Identified by Name/likeness
  • Voice Recording

And, included in any of the following:

  • Public News Media (newspapers, magazines, TV, radio, internet)
  • Ranken Jordan's marketing, public relations, and educational materials
  • Social Media Sites (Ranken Jordan's website, Facebook, Instagram)
  • Archives and historical displays

Limitations:

The undersigned agrees that Ranken Jordan may use and permit other persons to use the consented materials for purposes including, but not limited to, dissemination to hospital staff, physicians, health professionals and members of the public for educational and marketing purposes.

Right to Revoke Authorization & Expiration:

I understand that I have the right to revoke this Authorization at any time by contacting the Marking Department and that the revocation will be effective except to the extent that action has already been taken in reliance on this Authorization.  Unless earlier revoked, this Authorization will expire 100 years from the date of signature.

Re-Disclosure:

I understand that the information disclosed by this Authorization may be subject to re-disclosure by the recipient and no longer protected by Federal or state privacy requirements. 

Right-to-Refuse:

I understand that I do not have to sign this Authorization and that Ranken Jordan cannot make me sign this Marketing Authorization as a condition to getting treatment, making payments on any bills, or gaining enrollment or eligibility in any health insurance plan, unless the federal Privacy Regulations allow it.  I will receive no compensation for my participation.

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