Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Do you want to share your story on the podcast?
At first, I started Live Well Bipolar 4 years ago to share my personal story navigating the highs and lows living with bipolar. Since then, I have conducted over 190+ episodes featuring stories of others who share what has helped them craft their version of what Live Well Bipolar looks like for them. My mission with the podcast is to help my listeners feel less alone and feature more tools that make a difference. If you would like to contribute your story to continue this ripple effect then complete this form! :)
Love,
Paris Scobie - Host
Live Well Bipolar ™
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please provide your name and email:
*
Your answer
How did you find me or the podcast?
*
Your answer
What is your Instagram handle?
*
Your answer
Do you live with bipolar?
*
Yes, bipolar 1
Yes, bipolar 2
Yes, Cyclothymia
Yes, bipolar disorder unspecified
No but I am a professional working with clients diagnosed with bipolar
Is this your....
*
First time sharing my story on a podcast
I have shared my story on other podcasts before
What has been the biggest challenge you have faced so far living with bipolar?
*
Your answer
Please share what has been the most helpful for you in terms of navigating life with bipolar? (examples- therapy, supportive partner, medication, lifestyle changes, habits)
*
Your answer
What is your favorite episode of the podcast and why? (if you have not listened yet please go listen and come back and complete this)
*
Your answer
Where do you listen to podcasts the most?
*
Apple Podcasts
Spotify
Other
If you have not done so, can you leave a rating & review for the podcast on Apple Podcasts or Spotify? (DM a screenshot of your review to me via IG @livewellbipolar)
*
I left a rating on Spotify
I left a rating on Apple Podcasts
I left a rating AND review on Apple Podcasts
I left a rating and review on BOTH :)
I haven't listened yet but when I do I will leave a review
Why do you want to be a guest on the podcast?
*
Your answer
Please share anything about your story you would like me to know:
*
Your answer
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
Forms