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* 1. When were you diagnosed with a postpartum mood disorder (PPMD)?

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* 2. What age group do you fall into?

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* 3. How many times have you been pregnant?

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* 4. How many children do you currently have?

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* 5. What is your race/ethinicity?

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* 6. What is the highest level of school you have completed or the highest degree you have received?

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* 7. Which of the following categories best describes your employment status?

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* 8. What is your current income?

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* 9. Have you ever been diagnosed with any form of mental illness other than PPMD?

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* 10. What is your first name?

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* 11. At what email address would you like to be contacted?

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