Share your Story

Share Your Story with Bipolar Babes!

Fill out the form below to submit your story for inclusion on the Bipolar Babes website.

Are you at least 13 years of age?*
- Yes
- No
Unable to Proceed on This Form
The Bipolar Disorder Society of British Columbia cannot publish images or stories submitted to the website by children under 13 years of age without express written consent from a parent or legal guardian. For more information, please Contact Us.
For Youth under 18 Years Old
If you are between 13 years of age and 18 years of age, by submitting this form, you acknowledge, agree, and hereby represent to Bipolar Disorder Society of British Columbia that you have obtained the express prior consent or permission of your parent or legal guardian to publish your story on the Bipolar Babes Website.
For Adults
By submitting this form, you give express permission to Bipolar Disorder Society of British Columbia to publish your story on the Bipolar Babes website.
Name*
First
Alternate Name
- Yes
- No
Would you prefer to use an alternate name when we publish your story?
Name to Publish
Email*

This will not be published or made publicly visible.
Image
Accepted file types: jpeg, jpg, png, gif.
Please include an image to publish with your story if you have one. Otherwise, an image may be selected for you.
Type Your Story*
Private Notes
You can send a private message to Bipolar Babes. This will not be published with your story.
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