Mindfulmate - Bio Data Form
Please fill out this form to personalize your mental health support experience.
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Full Name:
Age:
Gender:
Select Gender
Male
Female
Other
Prefer not to say
University/College:
Year of Study:
Select Year
1st Year
2nd Year
3rd Year
4th Year
Graduate
Other
Mental Health Concerns (check all that apply):
Anxiety
Depression
Stress
Sleep Issues
Academic Pressure
Other
Preferred Support Methods:
Chat Support
Breathing Exercises
Journaling
Mood Tracking
Emergency Contact Name:
Emergency Contact Phone:
I consent to the collection and use of this information for personalized mental health support. I understand that this data will be stored locally and not shared without my permission.
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