SBMC Quiz

1

What's your main concern?* This field is required.

I have skincare concerns

I can't think clearly / I'm foggy and unfocused

I can't sleep well

I feel stressed or anxious most days

Body aches

2

When is your brain fog the worst?

First thing in the morning

Mid-afternoon slump

After a poor night's sleep

All day consistently

3

What do you think is causing it?* This field is required.

Poor sleep quality

Chronic stress / overwhelm

Just feel wired, but tired

4

What's the actual problem with your sleep?* This field is required.

I can't fall asleep (racing mind)

I fall asleep fine, but wake up during the night / can't back to sleep when I wake up

I sleep, but never feel rested

5

Does stress or screen time play a role at night?

Yes, I'm wired / anxious at bedtime

Yes, I'm on my phone / screens late

No, I just physically can't stay asleep

Not sure

6

How does stress show up for you?* This field is required.

Racing thoughts

Physical tension (tight chest, jaw, shoulders)

Irritability / short fuse

Low mood, feeling flat

7

When is it worst?

Mornings, before the day even starts

During the workday

Evenings, when things quiet down

It's pretty constant

8

What triggers it most?* This field is required.

First movement in the morning (stiffness)

After exercise or physical activity

Weather changes

9

What's your main skin care concern?* This field is required.

Dryness / sensitivity

Fine lines / loss of firmness

Dullness / uneven tone

Overall skin nourishment

Other

10

What is your current skin care routine?

I don't really have one

Basic cleanse + moisturize

I use actives (retinol, vitamin C, etc.) already

I've tried a lot and nothing sticks

11

What is your first name?

12

What is your email address?

example@example.com

13

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