Potential Writer's Survey

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 50% of survey complete.
Thank you for your interest in possibly writing an article for Visions Journal! Before we find out if your story is a good fit for an upcoming theme, we need to know a bit more about you. The questions we ask below are mostly optional, but the more we know about you and the different perspectives you bring, the better we can match you to a future issue.

Please keep in mind that we cannot guarantee that your story will be chosen for publication because we receive many requests each year but we will do our best to keep your information on file as we do seek specific stories quite regularly.

Email is the primary way we will contact you if an opportunity comes up. If your email address changes after you fill out this form, please let us know at visions@heretohelp.bc.ca

We value your privacy. All the information you give us below will be kept confidential to Visions staff only, will not be used for any other purpose than contacting you about writing for Visions, and is stored on a secure server.
 
Please note that if your answers describe recent or impending harm to your self or others, we are obligated to inquire further. If you need mental health support now, please contact bcpartners@heretohelp.bc.ca. 

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* 1. Where in British Columbia (Canada) do you live? 

At this time, we are seeking more information from potential British Columbia (BC)-based contributors only.

Please let us know where you currently live in BC. Or, if you grew up in BC and recently moved outside of the province, please tell us where you used to live.

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* 2. Contact information

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* 3. How would you describe your gender?

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* 4. What is your age? (a range is fine)

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* 5. How would you describe your ethnicity/ cultural heritage?

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* 6. (If applicable) If your connection to mental health or substance use problems is through a family member or friend instead of your own experience, please mark all that apply, and their ages. For example, if you had 1 family member with a mental illness, say your teen daughter, you would select the box 'My child, 13-18'

  12 or under 13-18 19-25 26-35 36-50 51-70 71-80 80+
My child
My parent
My spouse/ partner
My sibling
My friend

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* 7. Which mental health or substance use problem/s have you or your family/ friend experienced?

  Central to my own story Secondary to my own story Central to my family member or friend's story Secondary to my family member or friend's story
Attention deficit hyperactivity disorder (ADHD)
Anxiety disorder (includes OCD, Generalized Anxiety, Phobias etc.)
Depression
Bipolar disorder
Schizophrenia
Psychosis
Personality disorder
Eating disorders
PTSD
Dementia
Self harm
Suicide (attempt or loss of someone)
Alcohol use problems
Drug use problems
Problem gambling

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* 8. Which of these broad themes is your story most relevant to, if any? Please choose a maximum of 2. If none of these is a fit, tell us what your story is about in question 10.

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* 9. Which of these upcoming possible themes does your story fit into, if any? Please choose a maximum of 2. If none of these is a fit, tell us what your story is about in question 10.

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* 10. Please summarize your story in a short paragraph (maximum 10 sentences)

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