Mental Health

How old are you?

What is your gender

Male

Female

She-Male

Something else unclassified

Do you believe that you may be mentally challenged?

Yes

No

My doctor believes so

Check my records

Have you ever smoked Marajuana

Yes

No

Maybe

What was the question?

Have you ever stolen anything in your life?

Yes

No

Maybe

Marital Status?

Why do you think you have been selected for this survey

Because I am spun!

Because I am part of tribe!

Because I fit in with the mentally disturbed!

Do you have a genetic disorder?

Yes

No

I think so

Have you ever been committed?

Yes

No

Have you ever been prescribed Anti-Depressants?

Yes

No