Do you feel overwhelmed or stressed through the day?
Easily Overwhelmed
When I am busy
Massive to-do list, never check things off
Rarely stressed or overwhelmed
Do you have Children?
Yes
No
Do you experience highs and lows on a day to day basis
Yes Extreme Highs & Lows
No I am fairly consistent
More Lows than Highs
More Highs than Lows
Have you ever experienced any of the following conditions
Insomnia
Headaches/Migraines
Post Natal Depression
Anxiety
Depression
Stress
Do you find yourself feeling uncomfortable in any of the following situations?
Social Gatherings
Public Places
Interviews or Meetings
Making Phone Calls
Do you tend to overthink and over analyse different situations?
Yes
No
If you could change one of the following things, what would benefit your day to day life the most
Better Sleep Quality
Less Stress
Minimised Headaches/Migraines
Less Anxiety
More focus & concentration
Improved Mood in general
Do you experience menstrual cramping?
Yes
No
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