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PROJECT // Soft Galaxies
About Me
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Published
Let’s Talk!
PROJECT // Soft Galaxies
Interested? Please fill out this form to participate in Soft Galaxies! (Note: form will clear upon successful submission)
If you are a human and are seeing this field, please leave it blank.
Fields marked with an
*
are required
First Name
*
Last Name
City
*
Email
*
Phone
How old are you?
*
Under 18
19-25
26-35
36-50
51-65
66+
If you are under 18, do you have parental/guardian consent to partake in this project?
What mental illness(es) do you live with or have lived with in the past? Press CTRL + Left Click to select more than one:
*
Depression
Anxiety/Panic Disorders
Bipolar Disorder
Cylcothymic Disorder
Eating Disorders
Obsessive-Compulsive Disorder
Post Traumatic Stress Disorder
Borderline Personality Disorder
Schizophrenia or other Psychotic Disorders
Dissociative Identity Disorder (multiple personality disorder)
Depersonalization Disorder
Somatic Symptom Disorders
Other (please specify below)
If you selected "other" above, please explain further:
How long have you lived with your mental illness(es), and how recently were you diagnosed?
*
Please describe your treatment/lack thereof, and the way care practitioners have treated you, and how it all has made you feel:
*
Please describe how your mental illness(es) affect your life, how it makes you feel on your light days, average days, and heavy days:
*
Please describe the stigma or discrimination you've received:
*
Please describe your mental illness(es) in terms of nature(weather, plants, geology, terrain, climates, etc):
*
Please describe your mental illness(es) in terms of the elements(fire, water, air, earth, spirit, or other traditional elements):
*
Please describe your mental illness(es) in terms of colour(hue, shade, vibrance, presence, etc):
*
Please describe to me what kind of animal your mental illness(es) would be, and what that would be like:
*
Please describe your mental illness(es) in terms of the senses (smell, touch, taste, see, hear):
*
What's your favourite song or band, and how do they relate to your mental illness(es)?
*
Check if you would like your photos to remain anonymous:
Check if you are okay with (very tasteful) nudity or partial nudity:
What is 1+2?
*
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