Getting Started Survey
Welcome! Please complete this survey before beginning the experiment.
We will have you retake it at the end of the 9 days as well!
Please note Material Fees are $10 and includes shipping + handling
Do you have a doterra wholesale account
Yes, I will purchase my Adaptiv products
No, I will pay the $10 for materials for the study
What is your Mailing Address (for Materials)
1. Please select any of the symptoms of stress you have experienced over the last 12 months.
Back and/or neck pain
Feeling light-headed, faint, or dizzy
Sweaty palms or feet
Rapid heart rate
Having difficulty quieting the mind
Loss of sexual desire
1a. What time of day do you most struggle with your stress?
2. Please select any of the symptoms of Anxiety you have experienced over the last 12 months.
Difficulty controlling worry
Restlessness or feeling keyed up or on edge
Difficulty concentrating or mind going blank
Exaggerated startle response
Pins & Needles
Shortness of breath
2a. What time of day do you most struggle with your anxiety?
3. Have you been diagnosed with any of the 5 major types of anxiety disorders?
Generalized Anxiety Disorder (GAD)
Obsessive Compulsive Disorder (OCD)
Post Traumatic Stress Disorder (PTSD)
Social Phobia (Social Anxiety Disorder)
No FORMAL diagnosis - just self Diagnosis
4. Are you currently taking any prescription medication for your stress or anxiety?
5. What is one word that would describe what you would LIKE to feel if stress and anxiety weren't a major part of your day to day life?
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