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A unifying feeling for many people after ostomy surgery is that they can again lead a full and productive life. The Great Comebacks® Program recognizes these inspirational individuals, both in their personal lives and in their contributions to their communities.
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Great Comebacks® is sponsored by ConvaTec in partnership with the Crohn’s & Colitis Foundation (CCFA), the United Ostomy Associations of America, Inc. (UOAA), the Intestinal Disease Education and Awareness Society (IDEAS), Youth Rally, and the Wound, Ostomy and Continence Nurses (WOCN) Society.

Great Comebacks, Comeback Kids, and the Great Comebacks logo are registered trademarks of ConvaTec Inc.

© 2010 ConvaTec Inc.

 
 

Share Your Story

Could your story, or the story of someone you know, help guide or inspire others living with Crohn’s disease, ulcerative colitis, colorectal cancer or other diseases that can lead to ostomy surgery?

Your story is very important to us. To ensure that your story reaches us and to avoid technical difficulties, we recommend printing this form first and completing in a word processing document, then pasting your story into the fields below. This will ensure that you have time to complete your story before submitting to the Great Comebacks® Program.

*Required Field
* First Name:
* Last Name:
* Role:
Date of birth:
Gender:
Address 1:
Address 2:
City:
* State/Province:
Zip Code:
* Country:  
* Email Address:
Telephone:
Occupation:

Medical History

Note: Any medical information submitted to the Great Comebacks® Program will be retained in strict confidence by the committee and will not be used, disclosed or published without express written permission.
* Medical Condition:






* Surgery Type:



Surgery Date:

Your Story
Please include the following information in your story, or the story about someone you know:
  • How life changed or was affected by your/their medical condition and having an ostomy
  • How your/their “Comeback” was achieved and the positive effects that have resulted
  • The role that others (family members, nurses, surgeons) played in your/their “Comeback”
  • Any current activities or interests that you/they are now able to enjoy or participate in, and any specific dreams or goals that you/they have accomplished or wish to accomplish in the near future
  • The learnings or advice from your story that others might find beneficial
Please consider my story for a Great Comebacks® Award
Please consider my story for an Ina Brudnick Award (for young people between the ages of 17 to 24)
Please include me on the email distribution list for the Great Comebacks® newsletter

Privacy Statement
Your privacy is important to us. Data submitted to the Great Comebacks® Advisory Committee will not be sold, rented, or given away to any unrelated company, organization or individual without your written permission, except as required by law. The information we collect may be used to contact you, via e-mail or by regular mail, to provide you with information that we believe may be of interest to you. Your information may be transferred for processing and use to other countries and regions of the world. Any personal or medical information submitted to the Great Comebacks® Advisory Committee will be retained in strict confidence by the committee and will not be used, disclosed or published without express written permission of the applicant. This statement may be updated from time to time. Any questions or to correct your information, please contact greatcomebacks@convatec.com
*
 

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