Test Patient Arts Form

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Country
—Please choose an option—BrazilBruneiBulgariaBurkina FasoBurundiCôte d IvoireCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColumbiaComorosCongo (Congo-Brazzaville)Costa RicaCroatiaCubaCyprusCzechia (Czech Republic)Democratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (fmr. Swaziland)EthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (formerly Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorth MacedoniaNorwayOmanPakistanPalauPalestine StatePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSSierra LeoneSingaporeSSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe

Please select your art category:
poetryacrylicwatercolormixed mediadanceoilphotographypastelvideosculptureother

Which of the following best describes you and your entry?
person diagnosed with cancerfamily memberfriendcaregiver

Title of your artwork:

Upload your file
Technical formats:
For Artwork / Photography: JPG, TIF or EPS resolution of 300dpi
Picture Size starting with a 1000px width (max. Filesize: 100MB)

For Video: MP4, (max. Filesize: 100MB)

For Poetry: word or pdf
(include a translation to English if required)