Mental Brilliance Story Submissions
Please use complete sentences and share your story in a conversational tone. Submissions with paragraphs for each question are preferred.
Sign in to Google to save your progress. Learn more
Email *
Name *
Location
Occupation *
When are you available for a Web based Podcast interview? *
Interview will be conducted through ZOOM web conference platform and will last 20 minutes. ALL TIMES LISTED ARE EASTERN STANDARD TIME.
Mental Health Issue *
Mental Illness Diagnosis *
Tell us about your life. How old are you? Where do you live? What is it like there? What do you do professionally? What is your family life like? What do you do for fun? How do you spend your days? *
What led you to believe that you had mental health issues? How did you react to this discovery? *
Have you ever sought professional help for your mental health issues? If so, what was that experience like? If not, why not? *
How does this mental health issue impact your professional goals, personal success, family life and social life? *
Share a story about a time when you struggled to make sense of your mental health issue or struggled to overcome your mental health issue. *
How long has it been since you first recognized your mental health issue? What have you managed to achieve since then? How did you manage your mental health issue during this time? *
Do you believe that your mental health issue has helped you or hindered you in achieving your personal goals? Why? *
What are you most proud of about your achievements? *
Do you have advice for people who struggle with mental health issues? How can they learn to achieve personal success? *
Please list your website or social media account that we can visit to learn more about your accomplishments? Please list the url here. *
Which topics would you like to see covered on Mental Brilliance? *
Is there a personal issue that you would like wisdom and clarity on? How can I help you to become more successful in your daily life? *
By submitting your story you give MentalBrilliance.Com the right to publish, edit and promote your story on any platform, in a future publication and in marketing efforts. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms