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Creativity Guild Medical Questionnaire
In order to best serve this community and to ensure the safety of everyone who joins, please fill out this form in its entirety, print out a physical copy for your own records, and then burn it immediately.
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Name:
Your answer
Favourite colour:
Your answer
As a kid, what did you want to be when you grew up? (eg: cowboy, astronaut, etc...)
Your answer
How did you hear about The Creativity Guild?
Social media
Substack
Friend or relative
Co-worker
Billboards
Banner ad campaign on AOL
Skywriting
Geoff or Steve hassled me until I signed up
Other:
Clear selection
Why are you enrolling in The Creativity Guild?
Your answer
Have you had any past creative trauma? Please provide details:
Your answer
Do you have any creative allergies? Please provide details:
Your answer
How often do you exercise (your creativity)?
Daily
3-4x/week
1x/week
2x/month
2x/year
NEVER
Clear selection
Are you currently pregnant (with creative dreams and ambitions)?
Yes
No
Unsure
Clear selection
Please rate your creative energy levels
I have no talent or motivation
1
2
3
4
5
I wrote a novel yesterday
Clear selection
Do you have any of the following conditions that impede creativity?
Writer's block
Painter's block
Low creative self-esteem
Children of any age
Full-time employment
Other:
Are you currently undergoing any form of treatment?
Journaling
Secret novel project
Unfinished screenplay
Half-finished painting canvas
Reading The Artist's Way
Reading The War of Art
Other:
Clear selection
Family & employment history: have any of the following stunted your creativity?
Parents
Grandparents
Siblings
Spouse
Children
Teachers
Bullies
Bosses
Co-workers
Other:
Does the prospect of doing creative work result in any of the following:
Chest pain
Shortness of breath
Rashes
Anxiety
Sleeplessness
Numbness or tingling
Diarrhea
Other:
Clear selection
Is there anything else you would like to share?
Your answer
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