Brain Fog Quiz

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.Where should I send your Brain Fog Guide? By entering your email, you’ll also receive supportive, science-based and soul-aligned education on midlife health — including brain clarity, hormones, stress support and conscious living. I typically email once a week, and you can unsubscribe anytime.
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3
1. How often do you feel mentally foggy or unfocused during the day?* This field is required.
Rarely
Occasionally
Most days
Almost every day
4
2. Do you find yourself forgetting words, names, or why you walked into a room?* This field is required.
No
Sometimes
Frequently
Constantly
5
3. How would you describe your energy levels in the past week?* This field is required.
Consistent and good
Up and down
Low most of the time
Drained, even after rest
6
4. How many hours of quality sleep do you typically get per night?* This field is required.
7-8+ hours, restful
6-7 hours, okay
Less than 6 hours, interrupted
I have major sleep issues
7
5. Which of these do you most relate to lately? (check all that apply)* This field is required.
I have trouble concentrating
I feel overhwelmed by small decisios
I rely on caffeine or sugar to stay alert
I feel like I'm running on empty
I just don't feel like myself anymore
None of the above
8
Brain Fog ScoreThis is your Brain Fog Quiz Score
Should be Empty: