1. About Me (Optional)
Who am I? (You can share age, role, or keep this blank for anonymity.) I am
2. My Experience
What area of stigma have I faced? (Mental health, physical health, addiction, disability, race, gender, culture, etc.)
When did this begin? What was happening in my life at that time?
I have been affected by?
This began when? .
3. The Impact
How did this experience affect my daily life?
Did it change my relationships, work, confidence, or health?
This experience impacted my life by? .
4. The Stigma
What misconceptions or stereotypes did I encounter?
How did others react? Did I feel judged, isolated, or misunderstood? How did that make me feel emotionally?
One of the hardest parts was?
It made me feel? .
5. My Turning Point
Was there a moment when things started to change?
Did someone support me, or did I find strength within myself? What steps did I take to cope or heal?
Things started to change when.
This helped me .
6. Where I Am Today
How am I doing now?
Am I still healing, thriving, or advocating for others? What have I learned from this experience?
Today, I.
I’ve learned that .
7. My Message of Hope
What would I say to someone going through something similar? What advice or encouragement would I give?
If you are going through something similar, I want you know.