LET’S MAKE INSURANCE COMPANIES AND SHITTY DOCTORS VERY UPSET.

Information uploaded to the form below will be used for a new mixed media project depicting the shortcomings of the American medical industry and Insurance apparatus. Please follow the instructions for each section. Your name is technically required, but you can use your initials or a pseudonym. Whatever you are most comfortable with. Please redact any personal and identifiable information which you do not want added to the project.

Name

First Name

Last Name

How did you hear about this project?

What happened at the doctor?

You can add as much detail as you are comfortable with in this section. This is to provide contextual support for those of you who do not have an insurance denial, but have a story to tell regarding poor medical treatment/discriminiation/denial of care

Tell me your insurance horror story

You can add as much detail as you are comfortable with in this section. This is to provide contextual support for those of you who do have an insurance denial.

Confirmation of Submission

By choosing YES, I confirm that the information I have submitted can be employed for public display and purchase by Allison Kolarik on the aforementioned project, due out in Summer 2025.