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* 1. What is your name? If you want to remain anonymous use a fake name. Your responses (or part of them) may be read on the podcast or published.  

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* 2. What, if any, gender do you identify with?

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* 3. What are some of the things you tell yourself about yourself?

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* 4. Do you have any comments or suggestions to make the Mental Illness Happy Hour podcast better?

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