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Community Mural Input

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Who is filling out this survey?

Someone with mental illness/mental health issues (or helping someone with mental illness fill it out)

Someone delivering services to people with mental illness/mental health issues

A friend/family member of someone with mental illness/mental health issues

*Optional Contact Information

First Name

Last Name

Phone

Email Address

A mural is a big piece of artwork on an outdoor or indoor wall of a building. What ideas or themes about mental illness or wellness would you like it to show?

What would you like the community to know about mental illness?

What would you like the community to know about people with mental illness?

What is the most important thing to you to support recovery?

Is there a location for the mural you would like to suggest. (The wall must be in public location in Columbia city limits, preferably outdoors, greater than or equal to 800-900 sq ft)

Anything else you would like to add or say?

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