{"id":109,"date":"2025-05-13T16:48:06","date_gmt":"2025-05-13T16:48:06","guid":{"rendered":"https:\/\/anachronist.co\/?page_id=109"},"modified":"2026-04-20T04:16:15","modified_gmt":"2026-04-20T04:16:15","slug":"interest-form","status":"publish","type":"page","link":"https:\/\/anachronist.co\/?page_id=109","title":{"rendered":"Interest Form"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Welcome to the Anachronist Collective. I&#8217;m sorry you find yourself with a chronic or mysterious illness but I&#8217;m so happy you&#8217;re here. And happy to know you&#8217;re thinking about joining the Collective. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Life didn&#8217;t end at diagonosis and I want to help you adapt, overcome, and find joy. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please fill out these questions so I can get to know a little more about your story. Even though we are more than our symptoms, they are still a huge part of our lives and I want to honor that. <\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-794e3cfa wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:100%\">\n<div class=\"forminator-guttenberg\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-270 forminator-design--bold  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-270\" data-uid=\"6a455349b8c92\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-270\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-270 forminator-design--bold  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"270\"\n\t\t\t\t data-color-option=\"theme\" data-design=\"bold\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6a455349b8c92\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_6a455349b8c92\" id=\"forminator-field-name-1_6a455349b8c92-label\" class=\"forminator-label\">Name<\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1_6a455349b8c92\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a455349b8c92\" id=\"forminator-field-email-1_6a455349b8c92-label\" class=\"forminator-label\">Email Address<\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6a455349b8c92\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_6a455349b8c92\" id=\"forminator-field-textarea-1_6a455349b8c92-label\" class=\"forminator-label\">What brought you to the Anachronist Collective?<\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_6a455349b8c92\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_6a455349b8c92\" id=\"forminator-field-textarea-2_6a455349b8c92-label\" class=\"forminator-label\">What do you want to make sure to get from this coaching relationship? (2 or 3 things)<\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_6a455349b8c92\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-6a455349b8c92-label\"><span id=\"forminator-radiogroup-radio-1-6a455349b8c92-label\" class=\"forminator-label\">What area do you feel you are struggling with MOST right now?<\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-6a455349b8c92\" class=\"forminator-radio\" title=\"Hope and Faith\"><input type=\"radio\" name=\"radio-1\" value=\"one\" id=\"forminator-field-radio-1-1-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Hope and Faith<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-6a455349b8c92\" class=\"forminator-radio\" title=\"Friends and Family\"><input type=\"radio\" name=\"radio-1\" value=\"two\" id=\"forminator-field-radio-1-2-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Friends and Family<\/span><\/label><label id=\"forminator-field-radio-1-label-3\" for=\"forminator-field-radio-1-3-6a455349b8c92\" class=\"forminator-radio\" title=\"Love and Relationships\"><input type=\"radio\" name=\"radio-1\" value=\"Love-and-Relationships\" id=\"forminator-field-radio-1-3-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-1-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Love and Relationships<\/span><\/label><label id=\"forminator-field-radio-1-label-4\" for=\"forminator-field-radio-1-4-6a455349b8c92\" class=\"forminator-radio\" title=\"Work and School\"><input type=\"radio\" name=\"radio-1\" value=\"Work-and-School\" id=\"forminator-field-radio-1-4-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-1-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Work and School<\/span><\/label><label id=\"forminator-field-radio-1-label-5\" for=\"forminator-field-radio-1-5-6a455349b8c92\" class=\"forminator-radio\" title=\"Life Goals\"><input type=\"radio\" name=\"radio-1\" value=\"Life-Goals\" id=\"forminator-field-radio-1-5-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-1-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Life Goals<\/span><\/label><label id=\"forminator-field-radio-1-label-6\" for=\"forminator-field-radio-1-6-6a455349b8c92\" class=\"forminator-radio\" title=\"Accomodations\"><input type=\"radio\" name=\"radio-1\" value=\"Accomodations\" id=\"forminator-field-radio-1-6-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-1-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Accomodations<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-2-6a455349b8c92-label\"><span id=\"forminator-radiogroup-radio-2-6a455349b8c92-label\" class=\"forminator-label\">What area do you feel you are struggling with SECOND most right now?<\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-6a455349b8c92\" class=\"forminator-radio\" title=\"Hope and Faith\"><input type=\"radio\" name=\"radio-2\" value=\"one\" id=\"forminator-field-radio-2-1-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Hope and Faith<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-6a455349b8c92\" class=\"forminator-radio\" title=\"Friends and Family\"><input type=\"radio\" name=\"radio-2\" value=\"two\" id=\"forminator-field-radio-2-2-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Friends and Family<\/span><\/label><label id=\"forminator-field-radio-2-label-3\" for=\"forminator-field-radio-2-3-6a455349b8c92\" class=\"forminator-radio\" title=\"Love and Relationships\"><input type=\"radio\" name=\"radio-2\" value=\"Love-and-Relationships\" id=\"forminator-field-radio-2-3-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-2-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Love and Relationships<\/span><\/label><label id=\"forminator-field-radio-2-label-4\" for=\"forminator-field-radio-2-4-6a455349b8c92\" class=\"forminator-radio\" title=\"Work and School\"><input type=\"radio\" name=\"radio-2\" value=\"Work-and-School\" id=\"forminator-field-radio-2-4-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-2-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Work and School<\/span><\/label><label id=\"forminator-field-radio-2-label-5\" for=\"forminator-field-radio-2-5-6a455349b8c92\" class=\"forminator-radio\" title=\"Life Goals\"><input type=\"radio\" name=\"radio-2\" value=\"Life-Goals\" id=\"forminator-field-radio-2-5-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-2-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Life Goals<\/span><\/label><label id=\"forminator-field-radio-2-label-6\" for=\"forminator-field-radio-2-6-6a455349b8c92\" class=\"forminator-radio\" title=\"Accomodations\"><input type=\"radio\" name=\"radio-2\" value=\"Accomodations\" id=\"forminator-field-radio-2-6-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-2-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Accomodations<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_6a455349b8c92\" id=\"forminator-field-textarea-3_6a455349b8c92-label\" class=\"forminator-label\">What is your chronic illness story?<\/label><textarea name=\"textarea-3\" placeholder=\"Feel free to be as specific or vague as you&#039;d like.\" id=\"forminator-field-textarea-3_6a455349b8c92\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-4\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_6a455349b8c92\" id=\"forminator-field-textarea-4_6a455349b8c92-label\" class=\"forminator-label\">How is your life different now with your chronic illness? What do you no longer have that you miss?<\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4_6a455349b8c92\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-3-6a455349b8c92-label\"><span id=\"forminator-radiogroup-radio-3-6a455349b8c92-label\" class=\"forminator-label\">Where are you on your chronic illness journey?<\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-6a455349b8c92\" class=\"forminator-radio\" title=\"Something is weird with my health but I don&#039;t know where to start.\"><input type=\"radio\" name=\"radio-3\" value=\"one\" id=\"forminator-field-radio-3-1-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Something is weird with my health but I don't know where to start.<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-6a455349b8c92\" class=\"forminator-radio\" title=\"I&#039;m seeing doctors but I still don&#039;t have a name, just a lot of symptoms.\"><input type=\"radio\" name=\"radio-3\" value=\"two\" id=\"forminator-field-radio-3-2-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I'm seeing doctors but I still don't have a name, just a lot of symptoms.<\/span><\/label><label id=\"forminator-field-radio-3-label-3\" for=\"forminator-field-radio-3-3-6a455349b8c92\" class=\"forminator-radio\" title=\"I just got a diagnosis. But what does it mean??\"><input type=\"radio\" name=\"radio-3\" value=\"I-just-got-a-diagnosis.-But-what-does-it-mean??\" id=\"forminator-field-radio-3-3-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I just got a diagnosis. But what does it mean??<\/span><\/label><label id=\"forminator-field-radio-3-label-4\" for=\"forminator-field-radio-3-4-6a455349b8c92\" class=\"forminator-radio\" title=\"I got a diagnosis 6 months ago or longer and I am exploring community and researching my condition.\"><input type=\"radio\" name=\"radio-3\" value=\"I-got-a-diagnosis-6-months-ago-or-longer-and-I-am-exploring-community\" id=\"forminator-field-radio-3-4-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I got a diagnosis 6 months ago or longer and I am exploring community and researching my condition.<\/span><\/label><label id=\"forminator-field-radio-3-label-5\" for=\"forminator-field-radio-3-5-6a455349b8c92\" class=\"forminator-radio\" title=\"I know about my condition and some of the resources\/community for it.\"><input type=\"radio\" name=\"radio-3\" value=\"I-know-about-my-condition-and-some-of-the-resources-community-for-it.\" id=\"forminator-field-radio-3-5-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I know about my condition and some of the resources\/community for it.<\/span><\/label><label id=\"forminator-field-radio-3-label-6\" for=\"forminator-field-radio-3-6-6a455349b8c92\" class=\"forminator-radio\" title=\"I know about my condition, I&#039;m tracking research about it, and am actively part of the community.\"><input type=\"radio\" name=\"radio-3\" value=\"I-know-about-my-condition,-I&#039;m-tracking-research-about-it,-and-am-actively-part-of-the-community.\" id=\"forminator-field-radio-3-6-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I know about my condition, I'm tracking research about it, and am actively part of the community.<\/span><\/label><label id=\"forminator-field-radio-3-label-7\" for=\"forminator-field-radio-3-7-6a455349b8c92\" class=\"forminator-radio\" title=\"I know about my condition and others outside of it; I&#039;m a chronic illness expert.\"><input type=\"radio\" name=\"radio-3\" value=\"I-know-about-my-condition-and-others-outside-of-it;-I&#039;m-a-chronic-illness-expert.\" id=\"forminator-field-radio-3-7-6a455349b8c92\" aria-labelledby=\"forminator-field-radio-3-label-7\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I know about my condition and others outside of it; I'm a chronic illness expert.<\/span><\/label><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Submit<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"f3001d8fc9\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F109\" \/><input type=\"hidden\" name=\"form_id\" value=\"270\"><input type=\"hidden\" name=\"page_id\" value=\"109\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/anachronist.co\/?page_id=109\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Welcome to the Anachronist Collective. I&#8217;m sorry you find yourself with a chronic or mysterious illness but I&#8217;m so happy you&#8217;re here. And happy to know you&#8217;re thinking about joining the Collective. Life didn&#8217;t end at diagonosis and I want to help you adapt, overcome, and find joy. Please fill out these questions so I [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-109","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/anachronist.co\/index.php?rest_route=\/wp\/v2\/pages\/109","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/anachronist.co\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/anachronist.co\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/anachronist.co\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/anachronist.co\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=109"}],"version-history":[{"count":5,"href":"https:\/\/anachronist.co\/index.php?rest_route=\/wp\/v2\/pages\/109\/revisions"}],"predecessor-version":[{"id":271,"href":"https:\/\/anachronist.co\/index.php?rest_route=\/wp\/v2\/pages\/109\/revisions\/271"}],"wp:attachment":[{"href":"https:\/\/anachronist.co\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}