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Scientific Research
FAQs
Press Room
About Us
Meet the Team
Contact Us
Prescriber Information
Brain Fog Questionnaire
Von Greer
2025-07-26T10:52:19+00:00
Step
1
of
8
12%
1. Do you find yourself having a general sense of forgetfulness, difficulty remembering names, dates, or events?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
2. Do you have difficulty focusing on tasks or maintaining train of thought during conversations?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
3. Do you feel like your thinking processes have slowed down and you dread taking on new tasks?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
4. Do you find it challenging to maintain concentration in activities or conversations for an extended period of time?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
5. Do you struggle to recall words or have "tip-of-the-tongue" moments where you can't think of the right word?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
6. Do you find it difficult to juggle multiple tasks or switch between tasks smoothly?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
7. Are you finding it increasingly difficult to solve complex problems?
(Required)
Regularly (daily)
Often (3-4 times a week)
Sometimes (1-2 times a week)
Occasionally (1-2 times a month)
Rarely (less than monthly)
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(Required)
First
Last
Email
(Required)
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