TI Symptoms, Medications, And Results
The purpose of the survey is to show that the TI population responds very, very differently than the non-TI population to medication; it should show that TIs are a distinct population set and not mentally ill. This survey is designed to log TI symptoms with the medication prescribed for the symptom and the results of taking the medication(s).
NOTE: AFTER SUBMITTING THIS FORM, YOU WILL HAVE THE OPTION TO MAKE MORE ENTRIES.
Please provide an anonymous email address
Take 5 minutes and create an anonymous gmail address to be used for this and future surveys or leave this blank. An email is preferred.
Please select the TI symptom you were experiencing
You will have the opportunity to select more symptoms.
V2K Voices and Tinnitus
Body Parts Vibrating
Severe Brain Tension
If you chose "Other Symptom" in the previous question, please state what the symptom was and describe it.
Please limit your answer to one symptom. You will have the ability to enter in more.
How severe was your symptom?
When did the symptom first start?
How old were you when the symptom first started?
How often did/do you experience the symptom?
Continuously 24/7 365 days a year
Several times a day
Several times a week
Several times a month
Several times a year
Once a year or more
If you chose "Other", please describe the frequency that you experienced the symptom.
Please list the medication or medications that you were prescribed for the symptom, the dosage, and the time of day that you took them.
Did the medication(s) alleviate your symptom?
If the medication worked most of the time but also had times where it failed to cure your symptoms, please describe the failed experiences.
If you have any comments about the symptom, the medication, and the results, list them here.
What was your age when you first started taking the medication?
Approximate date you started taking the medication
Approximate date you stopped taking the medication
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