Memorial Submissions

Thank you so much for reaching out to Truth Pharm, and sharing your story with us. It is our hope to share your memorial tribute with our growing community, so that we can grow a national network of caring people who want to work to raise awareness and reduce the stigma associated with substance use disorders, and advocate for policy change to improve treatment options.

To continue the submission process, please complete the form below. Thank you for sharing with us.

Your Name (required)

Your Email (required)

The following information is required*

2. The first last name, age when passed and date when passed of your loved one.

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3. Their family relationships (such as parent, brother, father, son, etc.)

4. Your relationship to the loved one - you must be a parent, spouse, son, daughter, sibling or grandparent to submit. Please verify that you are authorized to submit this information

6. Provide their city, county and state.

7. Would you like to have your loved one to be included on our interactive map? Please type "yes" or "no" to accept these terms.

Your Memorial (required)

Please include your memorial in the area below. Please note that this box has a 3000 character limit. We recommend writing your tribute in a wordprocessing program and using the copy/paste feature to paste your tribute into the box for submission.


By submitting your memorial tribute and photo you are expressing your permission to use their image in Truth Pharm productions which could include banners, videos, posters, etc. and may appear in print or published through social media, news or other outlets. You are authorizing Truth Pharm, Inc. of your approval to use your submission on their website, social media pages including Facebook and Twitter, and other means of communication as they may apply. You also attest that the image and memorial you submit are not the intellectual property of anyone else other than yourself. Truth Pharm reserves the right to withhold publication of any submission, and your submission does not guarantee publication. To continue with your submission, please accept these terms by checking the box below. Thank you. Please type "yes" or "no" to accept these terms

Photo Submission

A clear picture of your loved one (No words on the photos please). Please attach your photo in .jpg form. We are unable to accept submissions over 5MB.