Neurofeedback 24-hour follow-up
This is for you to fill out roughly 24-48hours later regarding your last session.
Name *
Today's Date *
MM
/
DD
/
YYYY
How did you sleep last night? *
Did you go to bed at the usual time? *
Did it take more or less time to fall asleep? *
Did you sleep through the night? *
When did you first wake up? *
Time
:
Is that a normal time or a normal amount of sleep before you first wake up? *
Did you have any nightmare/terrors? *
How would you rate your anxiety over the last 24-hours on a scale of 0-10? *
How was your mood over the last 24-hours? *
How was your emotional regulation? *
Did your sensitivity diminish or heighten? *
Did you have more fun or felt more positive in the last 24-hours than you have recently? *
Did you feel more negative or depressed in the last 24-hours than you have recently? *
Were you irritable? *
Did you behave impulsively in the last 24 hours? If so, write how in the "other" slot *
How was your appetite? *
Did you feel more or less hungry? *
Did you have nausea? *
Were there any issues in your stomach area? *
Was your heart racing or did you feel speed up? *
Did you feel more or less mentally sharp? *
How was reading? Were you able to maintain the usual reading speed? How was your understanding of the material? *
Was your stool more loose or stiff? *
Did you have more bowel movements than usual? *
Did you have a headache? If so, 0-10 (0 being none and 10 being the worst) *
None
Worst
Were you dizzy? *
Did you have eye strain? *
Were you more clumsy than usual? *
Did you have trouble getting a full breath? *
Did you have persistent pain or muscle tightness in your neck, shoulders, or lower back? *
Did you have persistent pain or muscle tightness in any other part of your body? If so, write where in you body in the "other" slot. *
How many days are the effects of NFB lasting? (in days is good) *
Was there anything unusual that happened in the last 24-hours that happened even if you think it was unrelated to neurofeedback? *
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