Need someone to listen? Youth ages 12–18 can request a supportive conversation with Perfectly Unperfect Minds about feelings, everyday challenges, coping skills, and finding support.
PUM offers mental-health education and supportive conversations, not therapy or crisis care. This form is not monitored for emergencies. Submitting a request does not confirm an appointment.
How we use this information: PUM uses this information to review and arrange conversation requests. Access is limited to the PUM team members who need it to review and arrange requests. Records are stored in our organization's Google account (Google Forms) for only as long as we need to review and follow up on your request, and you can ask us to delete your information at any time. We are finalizing a written retention schedule and will publish it in our Privacy Policy.
Questions about your information? Email perfectlyunperfectminds@gmail.com or call (470) 804-1047.
If someone's safety is at risk, information may need to be shared with people who can help. If you are in danger or thinking about harming yourself, call or text 988, text "GA" to 741-741, or call 911. Those services are free, confidential, and available around the clock.
Heart-to-Heart Request Form
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Email perfectlyunperfectminds@gmail.com or call (470) 804-1047.
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