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Participating in Expressions of Addiction


In addition to enrolling participants through treatment and education centers, we welcome interested parties to participate in Expressions of Addiction. Do you have a story to tell about addiction? Would you like your photograph included in the project? Tell us your story and a little bit about yourself. For example, tell us how has addiction affected you or those near you? Tell us about your addiction or your recovery from addiction.

Please fill out the form below, or alternatively you can print a copy of the participant consent form and fax it to us at 1-781-306-8629. Adobe Acrobat required for the printable consent form.

Participant's Full Name    
Date of Birth   
Gender  Male     Female  
City, State  Zip Code 
Telephone Number   
E-mail Address   
Would you like us to use your real name? Yes No  
If no, what pseudonym should we use?
Tell us your comments or how addiction has affected you or those near you:



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