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Breast and Cervical Cancer Control Program

Testimonials

Do you have a story about how the NC BCCCP program has helped you or impacted your life in some way? Maybe you had a cancer diagnosed through the program or maybe enrollment in the program enabled you to receive your first cancer screening. Whatever your story is, we want to hear about it.

Please complete and submit the following form to share your NC BCCCP testimonial.

(* Items flagged with an asterisk are required.)

Testimony Submission Form
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(Complete this field if you would like a copy of your testimonial sent to you. You can also obtain a copy by printing the confirmation page which is provided after successful submission of your testimony.)

reCAPTCHA Instructions, Disclaimer, and Overview

Instructions

To finish submitting your feedback, please complete the reCAPTCHA image verification challenge above (if displayed) and then press the "Send Site Recommendation" button.

The words in the image verification come from scanned books. By typing them, you help to digitize old texts.

Disclaimer

The Breast and Cervical Cancer Control Program has no control over the images/words displayed in the reCAPTCHA. BCCCP does not endorse or adhere to views or opinions expressed or perceived by any of the images/words in the reCAPTCHA tool. BCCCP undertakes no responsibility to update or review any reCAPTCHA images/words.

If you do not agree with the use of the reCAPTCHA or if you find reCAPTCHA words offensive, you may contact us to arrange another way of submitting your feedback.

Overview

Why are you being asked to complete the reCAPTCHA challenge? The reCAPTCHA, a 3rd-party image verification tool, helps identify the user as a human (rather than a spam-generating computer) and reduces the likelihood of this form being used for unintended purposes.

reCAPTCHA Quick Help:

  • If you use the audio challenge, type the numerals/digits without spaces (do not spell out the numbers).
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Where can I find more information? Visit Google's reCAPTCHA page.