About Us
Services
Practitioners
Group Sessions
Resources
FAQ
Contact Us
Book Online
About Us
Services
Practitioners
Group Sessions
Resources
FAQ
Contact Us
Anonymously share your story today!
*
Indicates required field
Age
*
Less than 13
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years
21 years
22 years
23 years
24 years
25 years
older than 25 years
prefer not to say
Pronouns
*
Her/She
He/Him
They/Their
What I struggled with
*
What helped me
*
Monthly Theme
*
Future vs Past (January)
Support vs Loneliness (February)
Growth vs. Death (March)
Self-Care vs Neglect (April)
Change vs Stagnation (May)
Happiness vs Sadness (June)
Excitement vs Boredom (July)
Relaxation vs Stress (August)
Confidence vs Insecurity (September)
Bravery vs Fear (October)
Focus/Productivity vs Distraction (November)
Belonging vs Isolation (December)
Please select a theme that corresponds to your submission. You can submit as many times as you like.
Share your story
*
Upload images (up to three) that support your story that you are comfortable sharing.
An image is not required to submit. Any images provided can and will be used by Three Story Clinic on their social media and website.
First supporting image
*
Max file size: 20MB
Please provide an image or images you are comfortable with sharing. An image is not required to submit. Any images provided can and will be used by Three Story Clinic on their social media and website.
Second supporting image
*
Max file size: 20MB
Please provide an image or images you are comfortable with sharing. An image is not required to submit. Any images provided can and will be used by Three Story Clinic on their social media and website.
Third supporting image
*
Max file size: 20MB
Please provide an image or images you are comfortable with sharing. An image is not required to submit. Any images provided can and will be used by Three Story Clinic on their social media and website.
If you would like to be contacted, please provide an email address. Your email address is NOT required to submit this form. But if you do provide your email address, please keep in mind you will no longer be submitting anonymously. We won't make your name public, but your email will be known to our staff who work on our social media accounts. If you do not wish to share your identity with Three Story Clinic and our staff, please do not submit your email address. Thank you.
email address
*
Submit
Learn more
about helping us grow our online community.
