Keeping Your Marbles:
Women's Brain Health Interest Survey

Your brain deserves as much attention as the rest of your body. Help us design a program that actually fits YOUR life, YOUR schedule, and YOUR biggest brain health concerns.

This survey takes about 4–5 minutes, and every response is completely confidential.

As a thank-you for your time, everyone who completes this survey will receive [a free brain-health guide / entry into our giveaway] and be first to know when registration opens.

What We're Trying to Achieve: This program is designed to (1) help women address their current health challenges, and (2) help them develop their own personalized brain protection plan, grounded in real science, tailored to their life stage, and built to last.

1. Your Interest Level
How interested are you in joining a physician-led brain health program designed specifically for women?

Using the scale below, please indicate your level of interest. A rating of 1 means you are not interested at all, while a rating of 10 means you are extremely interested. *

Not Interested (1)Interested (10)

2. How Did You Hear About Us?

Organization / Event *

3. Tell Us A Little About You

If you selected "Other", kindly drop a comment.

4. Topics of Greatest Interest
So many topics affect brain health — to help us prioritize, please select your TOP 5 overall (not all that apply).

Hormones & Life Stage.

Hormones & the Brain (perimenopause, menopause, HRT)

Family History / Genetic Risk (e.g., APOE4)

Brain Function & Daily Habits

Sleep & the Brain's Detox System (Glymphatic Health)

The Gut-Brain Connection

Memory Training & Cognitive Exercises

Stress, Cortisol & the HPA Axis

Mental & Emotional Wellbeing

Mental Health (emotional stress/trauma, depression, anxiety)

Caregiving Stress & Burnout

Eating Disorders

Medical & Risk Factors

If you selected "Other", kindly drop a comment..

5. Preferred Format

Select preferred choice: *

In-person

Virtual — Live Sessions

Virtual — Self-Paced / Recorded

Hybrid (mix of live + recorded)

6. Best Time of the Week for You

If sessions were held live, which time slot works best? (Select one.) Times shown are Eastern — let us know if you're in a different time zone. *

None of these work — my best time (and time zone) is

7. Program Length

Select preferred choice: *

4 weeks

6 weeks

8 weeks

12 weeks (3 months)

8. In Your Own Words

What is your single biggest concern or question about brain health and dementia prevention? *

9. Let's Stay Connected

Your information is kept strictly confidential and will never be sold or shared. We'll only use it to follow up about this program.

Full Name (Optional)

Email *

Phone *

Select preferred choice: *

Yes — you may contact me about this program and future brain health events.

No — please just record my survey response.

Thank you for helping shape a brain health program built for women, by a physician who cares.

— Dr. David Ajibade, Brain and Body Foundation

1. Your Interest LevelHow interested are you in joining a physician-led brain health program designed specifically for women?

2. How Did You Hear About Us?

3. Tell Us A Little About You

4. Topics of Greatest InterestSo many topics affect brain health — to help us prioritize, please select your TOP 5 overall (not all that apply).

5. Preferred Format

6. Best Time of the Week for You

7. Program Length

8. In Your Own Words

9. Let's Stay Connected

1. Your Interest Level
How interested are you in joining a physician-led brain health program designed specifically for women?

4. Topics of Greatest Interest
So many topics affect brain health — to help us prioritize, please select your TOP 5 overall (not all that apply).