We want to hear from you.
What is your name and age?
Where do you live?
What is your current situation? Is your city or town shut down? Are you in a house or apartment? Are you social distancing/self isolating alone or with a roommate, partner, or family member?
How are you feeling?
What is bringing you comfort right now?
What can we at Refinery29 do for you during this time? What do you want to read about right now?
What is your email address, so we can reach you with followup questions?
Never submit passwords through Google Forms.
This form was created inside of Refinery29. Report Abuse