Freedom Quest, Inc. is a not-for-profit 501(C) 3 organization offering free mental health - peer to peer counseling, depression support, and information resources within an online forum called Thera Chat, 1-800-SUICIDE

Thera-Chat General Survey

1. What is your diagnosis?

Depression/Anxiety

Bipolar

Schizophrenia/Psychosis

PTSD/Abuse Issues

No formal diagnosis

Other diagnosis

2. Do you use medication?
			Prescription
			Holistic
			Over-the-Counter
			No Medications

3. Gender?
			Male
			Female

4. Have you used a mental health chat before using Thera-Chat?

Yes

Name of other chatroom:

5. What is the best benefit of using a mental health chatroom?

Chatting with others that have the same diagnosis

Finding more information about your mental health

Learning about other medications

Other

6. Do you have other family members with mental health issues?
			Yes
			No
			Unsure

7. Are you seeing a psychologist/psychiatrist for mental health services?
			Yes
			No

8. Are you seeing a therapist/counselor for mental health services?
			Yes
			No

9. Would you like the availibility to mental health professional in the chatroom?
			Yes
			No

9a. Would you pay a fee for this service?
			Yes
			No

10. Would you be interested in private group chats?

Yes

Which ones:

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