Fears

1.

100% of survey complete.

Question Title

* 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.

Question Title

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

Male

Female

Transwoman

Transman

Genderfluid

Agender

Other (specify in box below)

Other (please specify)

Question Title

* 3. Share something you fear. The more detailed the better, including what you think will happen if that fear comes true.

Question Title

* 4. How old are you?

Under 18 (specify exact age in box marked "other")

18-19

20-29

30-39

40-49

50-59

60-69

70 or over (specify exact age in box marked "other")

Other (please specify)

Question Title

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