Is Your Brain Performing At Full Capacity?

Please complete the questionnaire below as accurately as possible. There are no “right or wrong” answers. Simply choose your level of agreement with the statements below so we can help gauge the health of your brain..

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  Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
I have trouble sustaining attention and can be easily distracted?
Quite often, I have trouble finding the right word to say
I find myself being more forgetful over the last few years
From time to time, I have trouble remembering appointments
I have even forgotten to take medications or supplements


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