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* 1. Name

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* 2. Age

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* 3. Gender

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* 4. How much does stress affect your quality of life?

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* 5. Please describe the causes of your stress or anxiety.

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* 6. Do you regularly consult others to help with your stress or anxiety? Select your primary influences.

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* 7. Please list your current anxiety and stress management techniques and describe what you like/dislike about them.

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* 8. How satisfied are you with your current treatment methods and stress management techniques?

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* 9. When you are in public, is it harder to manage your stress and anxiety? Why/Why not?

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* 10. Are you open to using a tool to help de-escalate your stress and anxiety?

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* 11. If there were a small, portable device that uses pulses of vibrations to influence the brain and de-escalate rising stress, how much would you want it? 

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* 12. Why?

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* 13. How much would you pay for this?

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* 15. How did you hear about CALM?

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