Name *

First Name

Last Name

Can you relate to any of the following? (Tick the option/s) that apply to you). *

I often feel a sense of urgency in getting things done.

It’s difficult to switch off my mind.

Brain fog.

I have lots of energy one minute/day, then crash the next.

I feel stuck often.

I have lots of ideas, but find it hard to materialise them.

Apathy.

Withdrawn from people.

I start good projects and find it difficult to bring them to completion.

I find it hard to fall asleep.

Procrastination.

I often wake up feeling tired despite having a full night of sleep.

I wake up during the night and struggle to fall asleep again.

Forgetfulness.

Most days I feel I don’t have enough time to get things done.

I don’t put enough effort into my personal relationships.

I put a lot of effort into my relationships and don't feel reciprocated by other/s.

I have IBS or other digestive issues.

I keep on choosing or naturally ending up with the wrong partners.

I want so much from life and feel I can’t achieve as much as I would like to.

I have been living in a chronic state of stress in the last couple of years.

I'm sensitive to lights or/and sounds or/and smell.

I have childhood trauma.

I have gone through some traumas in my adult years.

I don't have trauma.