Neurotransmitter Survey * 1. Is your temperament getting worse? Yes No OK * 2. Do you find yourself down or sad? Yes No OK * 3. Do you walk into rooms and forget why? Yes No OK * 4. Do you have a high stress level? Yes No OK * 5. Do you have an imbalance in energy levels? Yes No OK * 6. Do you feel overwhelmed, hopeless, depressed, or anxious often? Yes No OK * 7. Do you feel tired even after a full nights sleep? Yes No OK * 8. Do you experience disorganized attention? Yes No OK * 9. Do you have difficulty falling asleep, staying asleep, or getting into a deep sleep? Yes No OK * 10. How often do you have difficulty finishing tasks? Yes No OK DONE