1. Do you have trouble falling asleep?
1 out of 10
Do you have difficulty motivating yourself to get tasks accomplished?
2 out of 10
How is your physical health?
3 out of 10
How is your Emotional Health?
4 out of 10
Do you feel more irritability or have outbursts of anger?
5 out of 10
Do you withdraw from others or feel overwhelmed in groups of people?
6 out of 10
Do you struggle to regulate your caffeine, alcohol, or tobacco use?
7 out of 10
How prepared do you feel for daily tasks?
8 out of 10
Do you struggle to focus on tasks or stay motivated?
9 out of 10
Do you have good eating habits?
10 out of 10