Submit Your Story

This form is so you can submit your story regarding your accident, physical disability or brain injury.harleypenpad1
The idea behind all this is to give a greater understanding of the actual real-life symptoms and struggles resulting from a motorcycle accident.
This may sound harsh but we are not looking for those who are looking for sympathy or attention or those with the ‘my injury is worse in your injury’ attitude.
All we require is an honest and open write up including the issues that we don’t talk to people about because we are meant to be rufty tufty bikers. (Hence the ability to submit this anonymously)
You may inspire someone or at the very least let them know they are not alone, because as we know some of the symptoms of a head injury make you honestly feel like you’re going mad.


Your Name if no name is added it will be added anonymously

Do you wish to remain Anonymous?
YesNo

Your Email (this will never be published of passed on)

Title

Disability type and whether it was caused by a Motorcycle Accident. (Hold down ALT key to select multiple items)

Areas Affected
HeadNeckShouldersArmshandsRibsBackSpineHipsLegsFeetInternal OrgansBrain

This is just for context to allow the readers to see the difference (if any) a helmet made
YesNo

Your Story

Spam Filter (prove you are human (ish) 🙂 )

If Required, Attach any files you feel would suit your story