Sleep & Memory Test – Better Memory PM

This brief test will help you establish a baseline as of today.

How many bottles of Better Memory PM have you taken so far?

During the past 30 days how often were you able to fall asleep easily?

0 = Never

1 = Very Rarely

2 = Occasionally

3 = Quite Often

4 = Very Often

During the past 30 days how often were you able to fall back to sleep when you woke up too early or in the middle of the night?

0 = Never

1 = Very Rarely

2 = Occasionally

3 = Quite Often

4 = Very Often

During the past 30 days how often did you wake up feeling you had a good night’s sleep?

0 = Never

1 = Very Rarely

2 = Occasionally

3 = Quite Often

4 = Very Often

During the past 30 days how often did you feel you had trouble staying focused?

0 = Never

1 = Very Rarely

2 = Occasionally

3 = Quite Often

4 = Very Often

During the past 30 days how often did you feel you woke up with brain fog?

0 = Never

1 = Very Rarely

2 = Occasionally

3 = Quite Often

4 = Very Often

During the past 30 days how often were you able to recall today’s date without looking at the calendar?

0 = Never

1 = Very Rarely

2 = Occasionally

3 = Quite Often

4 = Very Often

Where did you hear about us?

Comments

Please fill out the following to receive your test results. Your privacy is important to us and we do not rent, sell or share your personal information with any third parties. All test results are kept confidential.

First Name *

Last Name

Email Address *

Age

The questionnaire above is a basic assessment for sleep quality and memory and every person is different. If you wish to receive a free consultation, please provide your phone number and the best time for our specialist to call you to discuss your need. We are here to help.

Phone (for a FREE phone consultation)

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