metaBRAIN Study - Submission Form
Name *
Please provide your preferred mailing address. *
Will you be able to take metaBRAIN according to the instructions and take each week’s assessment to the best of your ability? *
Do you have a daily supplementation routine? *
Do you feel like there are some aspects in your life (i.e. energy, work performance, etc) that can be improved? *
What healthy habits do you practice (i.e. journaling or meditation). List a maximum of five. *
How many days do you workout per week (including all physical activity such as hiking)? *
Do you live a lifestyle that requires peak performance, or work in a high-stress environment? *
Do you currently take any other supplements? If so, what are they? *
How much do you weigh (in lbs)? *
How many cups of coffee do you typically drink per day? If you take any supplements with caffeine be sure to include that amount as well. *
Example answer: 2 cups of coffee with 100 mg pre-workout per day
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Nuoptimal.