Full Name / 姓名 *

Age / 年龄: *

Gender / 性别 *

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1. Have you noticed changes in your mood, energy, or motivation that affect your daily activities? 您是否注意到情绪、精或动的变化，从影响到您的常活动？

2. Do you often struggle with sleep, such as difficulty falling asleep, staying asleep, or still feeling tired after resting? 您是否经常遇到睡眠问题，例如睡困难、法维持睡眠，或即使休息后仍感到疲惫？

3. Have you ever felt that stress, anxiety, or constant worry makes it hard to focus or enjoy daily life? 您是否曾觉得压、焦虑或持续担忧让您难以专注或享受常活

4. Have you tried therapy, medication, or other approaches to support your mental wellness? 您是否尝试过心理治疗、药物或其他法来持理健康

5. What treatments have you already tried to improve your mood or focus, and how effective were they? 您之前尝试过哪些方法来改善情绪或专注力？效果如何

6. Did you know that a typical TMS session is non-invasive, requires no downtime, and is completed in under 20 minutes? 您是否知道 TMS 疗程是侵性的，需恢复时间，并且通常在 20 分钟内完成

7. Since you’ve experienced challenges such as stress, anxiety, or low mood, would you consider TMS as a supportive option? 鉴于您经历过压、焦虑或情绪低落等情况，您是否会考虑将 TMS 作为种持性的选择？

I understand that this questionnaire is for screening purposes only and does not replace a medical evaluation. I consent to be contacted by iCareMindSpace for a consultation. 我明此问卷仅于初步筛查，并不能替代医学评估。我同意 iCareMindSpace 与我联系安排咨询。