Have you ever hit your head, had a concussion, or experienced a hard impact that left you feeling 'off'?
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Yes
No
How often do you struggle with brain fog, forgetfulness, or losing track of thoughts?
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Rarely, I feel sharp and clear-headed.
Occasionally, especially when stressed or tired.
Often, and it’s starting to affect my daily life.
Constantly—I feel like my brain just doesn’t work like it used to.
Do you find it harder to focus on tasks compared to a few years ago?
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No, I can focus well.
Sometimes, but I can usually push through.
Yes, I get distracted easily and struggle to complete tasks.
Absolutely, I feel overwhelmed and mentally drained all the time.
Do you experience frequent headaches or pressure in your head?
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Almost never.
Occasionally, especially after long days.
Regularly, and it interferes with my routine.
All the time, and nothing seems to help.
How well does your body recover after workouts, stress, or illness?
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Quickly, I bounce back fast.
Slower than before, but manageable.
I feel drained for days after minor stressors.
I never feel fully recovered or rested.
How often do you wake up feeling refreshed and energized?
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Almost every morning.
Sometimes, but I have sluggish mornings.
Rarely, I wake up tired no matter how much I sleep.
Never—I rely on caffeine just to function.
Do you struggle with falling or staying asleep?
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No, I sleep soundly through the night.
Occasionally, especially when stressed.
Often, I wake up multiple times or have restless nights.
Almost every night—I feel exhausted but can’t sleep.
How would you describe your mood and stress levels?
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Stable, I handle stress well.
Occasionally anxious or moody, but nothing extreme.
Frequently irritable, anxious, or overwhelmed.
Extreme highs and lows, with constant stress.
Have you noticed increased sensitivity to noise, lights, or crowded places?
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No, I handle sensory input just fine.
Sometimes, but only when I’m tired or stressed.
Yes, I avoid bright lights and loud environments.
Absolutely, even small stimuli feel overwhelming.
How often do you experience bloating, indigestion, or stomach discomfort?
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Rarely or never.
Occasionally, but nothing major.
Frequently, especially after eating.
Almost daily, and it’s affecting my quality of life.
When it comes to your brain health, what is your SINGLE biggest challenge right now? (Please be as detailed and specific as possible)
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