Thank you for your interest in sharing your story at our fourth annual "One Thing I Wish You Knew" (OTIWYK) community mental health event taking place on November 15, 2026. Please answer the questions below to help us understand your journey, your comfort level, and whether this opportunity is the right fit for you. Upon submission, someone from the OTIWYK team will be in contact with you regarding next steps. Your answers are confidential and help us make sure every speaker is ready, comfortable, and supported. If you have any questions, please reach out to [email protected]. Full Name* First Name Last Name Phone Number*  E-mail I am:* 13 years old14 years old15 years old16 years old17 years old18 years old19 years old20 years old and up12 years old or less City and State:* How did you learn about the event? Please share a summary of your mental health journey. (What happened, what youâve learned, and why you want to share it.) Example: "I struggled with anxiety during middle school and found support through therapy and art." Your Mental Health Story:* When did your most difficult mental health challenges arise? (Approximate dates or ages - for example: "Spring 2023" or "Age 14â15") đ Approximate Dates of Mental Health Crisis* đ Have you ever seen a psychiatrist?* YesNoPrefer not to answer Have you ever seen a therapist?* Yes, in the pastYes, in presentNo What helped you on your journey? Therapy / CounselingSupportive familySupportive friendsMedicationSchool counselorFaith / Spiritual supportSports or physical activityArts (music, writing, art, etc.)Support groups Did your mental health challenges ever affect these areas? SchoolFamily relationshipsFriendshipsSleepAppetiteBehaviorSafetyMoodEnjoyment of activities đ„ Did you ever receive a higher level of care for your mental health?* Day treatment programHospitalization (overnight or longer)Residential treatmentNone of these If yes, please share approximate dates (month/year if possible): (1 = just beginning, 5 = feel fully stable) đ How far do you feel you are in your mental health recovery?* 12345 Do you feel comfortable sharing your story publicly in front of a large audience * Yes, fully comfortableMaybe â Iâd like to talk moreNo Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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