Share Your Story Form

Home/Share Your Story Form
Share Your Story Form 2017-03-21T17:53:28+00:00

Paris Regional Medical Center wants to give you the opportunity to share your story of excellent care. Fill out the form below to show your appreciation for your care.  Just enter your name, email, phone number and you story.

Please be aware that these messages are printed, emailed or hand-delivered and we cannot guarantee privacy.  Some stories will be published on our website.  We recommend that you not provide any information that is confidential or private via this form.

Your Name:
E-mail:
Share Your Story: