Share a Story *Indicates a required field 1 of 12 Please upload your image(Required)Please note that if there are faces in the photo beside yours, they will be blurred to maintain privacy. We recommend that your photo does not include people other than yourself.Upload one supported image file (jpg, jpeg, png) max 1 MB. Accepted file types: jpg, jpeg, png, gif. Title of story(Required)Maximum 40 characters Date photo was taken(Required) This field is hidden when viewing the formGeocoder(Required)This field is hidden when viewing the formCoordinates(Required) Is the photo location outside BC?(Required) Yes No Click and drag the pin to show where you’d like the photo to display Story(Required)Impact story - please limit to 100 words (700 characters) Relevant themesplease select all that apply Other Air Quality Drought Ecosystems Extreme cold Extreme heat Flooding Food safety and security Mental health impacts Resilience and adaptive capacity Severe storms Stories with testimony Water quality and security Wildfire OptionalWe also want to hear your thoughts and ideas on climate solutions. What do you think could help people like you cope with climate change in the future? Would you be willing to answer some demographic information questions? Yes No We are collecting optional demographic information from participants. This data will allow us to better understand the unique climate change and health impacts of different populations and allow us to deliver responsive and more appropriate health services and supports to particular communities and populations.Optional:Age Under 18 18-29 30-49 50-65 Over 65 Optional:Gender Woman Man Non-binary Prefer not to say We are collecting optional demographic information from participants. This data will allow us to better understand the unique climate change and health impacts of different populations and allow us to deliver responsive and more appropriate health services and supports to particular communities and populations.Optional:Do you identify as Indigenous? Yes No Prefer not to say Optional:Do you have a chronic health condition that affects your wellness on most days? Yes No Prefer not to say We are collecting optional demographic information from participants. This data will allow us to better understand the unique climate change and health impacts of different populations and allow us to deliver responsive and more appropriate health services and supports to particular communities and populations.Optional:Do you have the financial resources to meet you and your family’s needs’? Never Occasionally Sometimes Often Always Prefer not to say Would you be interested in sharing a more in-depth testimonial about your experience? Yes No Optional: Please provide your email address so that we can stay in touchWe want to stay connected and keep you informed about the ecolens project
