Do you currently experience memory lapses that affect daily life? *

Never

Occasionally (once or twice a month)

Frequently (weekly)

Daily/Almost every day

How is your sleep quality? *

Amazing - 7-9 hours undisturbed + and feel energised in the mornings.

Can be somewhat disrupted or less than desired hours obtained

Often get poor quality or hours of sleep with it affecting me in the day.

Horrible - Hardly sleep, very disturbed or only get a few hours a night or less, majorly affecting my functioning in the day.

How healthy is your diet? *

Exceptional - I dont eat any proccessed food - only balanced wholefood

Mostly wholefoods with the occasional packaged foods & eating out

A mix of healthy and processed foods (25% or more processed)

Heavy in processed, sugary, or fast foods

How hydrated are you daily? *

2-3 Ltrs high quality filtered water a day

1-1.5 Ltrs high quality water / or 2+ Ltrs tap water a day

1-3 cups (less than 1 L) - any type of water a day

Does the water in my tea and coffee count? / Or I only drink soda/juice

How often do you exercise?

I get varied types of exercise through the week - 5+ times a week

I walk or do lower intensity exercise 3+ times a week

I clean the house and do the odd walk or exercise here and there

Never - I am very inactive

Do you have active medical conditions that affect brain health? (e.g., diabetes, vascular disease, infections, oral health issues, hearing loss/tinnitus, thyroid condition, brain injury past or present)

None

1 - 2 of these

3 of these

4 or more of these / or many other health conditions too

Do you feel mentally engaged and socially connected?

Often, I stay active and connected weekly

I have family and friends I keep in touch with regularly and do some activities every month or so

I just see a couple of close people in my life occassionally

No, I don't do much at all or see people much at all.

How determined do you feel to take action toward brain healing?

Very determined - I'm ready to do what's needed for healing

I am pretty determined but won't take action on everything - i'll see

I'm unsure if now is the right time for me - I don't know when will be

I don't want to take any action at all

Do you believe the brain can recover, improve and heal?

Absolutely - I know it does and will

I am pretty confident it has the capacity to, but a bit unsure how much

Maybe the brain's deterioration can be slowed somewhat

Doubt it - improvement or healing isn't possible

How supported do you feel by loved ones in this journey?

I have a very supportive person/group of people in my life

I have some support in my life that I know will help me if I ask

I could try get some support from community / maybe hesitant support

I have no support / not at all supported

Which of these changes do you feel you are up for implementing for you right now? (choose as many as you feel acheivable)

A. Improving my daily hydration and nutrition

B. Adding gentle movement to my routine.

C. Tracking my symptoms & treatment responses.

D. Reducing stress and improving sleep

E. Following a natural, structured guidance plan.

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