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When scoring, use the following numbers for degree of severity:
0 = Never 1 = Sometimes 2 = Usually 3 = Almost always 4 = Always

Check the following that is appropriate:

Never Sometimes Usually Almost always Always Low energy levels

Never Sometimes Usually Almost always Always Trouble sleeping

Never Sometimes Usually Almost always Always Mid-morning energy slump

Never Sometimes Usually Almost always Always Mood swings throughout the day

Never Sometimes Usually Almost always Always Feel stressed

Never Sometimes Usually Almost always Always Can't concentrate well

Never Sometimes Usually Almost always Always Irritable

Never Sometimes Usually Almost always Always Nervous

Never Sometimes Usually Almost always Always Mid-afternoon energy slump

Never Sometimes Usually Almost always Always A Little down or depressed

Never Sometimes Usually Almost always Always Very tired at night

Never Sometimes Usually Almost always Always Tension headaches

Never Sometimes Usually Almost always Always Not as alert as I should be

Never Sometimes Usually Almost always Always Feel tense

Never Sometimes Usually Almost always Always Poor hair texture

Never Sometimes Usually Almost always Always Eyes tired, dry or itchy

Never Sometimes Usually Almost always Always Sad feeling

Never Sometimes Usually Almost always Always Negative attitude

Never Sometimes Usually Almost always Always General weakness

Never Sometimes Usually Almost always Always Easily upset

Never Sometimes Usually Almost always Always Anxiety

Never Sometimes Usually Almost always Always Have more minor illness than others (colds, flu)

Never Sometimes Usually Almost always Always Rough, dry scaly skin

Never Sometimes Usually Almost always Always Generally unhappy

Never Sometimes Usually Almost always Always Don't feel like doing fun things I used to do

Never Sometimes Usually Almost always Always Foot, leg or other muscle cramps

Never Sometimes Usually Almost always Always Mild forgetfulness or absentmindedness

Never Sometimes Usually Almost always Always "Pink toothbrush" after brushing teeth

Never Sometimes Usually Almost always Always Bruise easily

Never Sometimes Usually Almost always Always Feel immune system is weak

Never Sometimes Usually Almost always Always General fatigue

Never Sometimes Usually Almost always Always Memory recall not very fast

Never Sometimes Usually Almost always Always Mild aches & pains that come & go

Never Sometimes Usually Almost always Always Acne

Never Sometimes Usually Almost always Always ADD

Never Sometimes Usually Almost always Always Allergies

Never Sometimes Usually Almost always Always Arthritis

Never Sometimes Usually Almost always Always Asthma

Never Sometimes Usually Almost always Always Cancer

Never Sometimes Usually Almost always Always Diabetes

Never Sometimes Usually Almost always Always Fibromyalgia

Never Sometimes Usually Almost always Always Heart Disease

Never Sometimes Usually Almost always Always High Blood Pressure

Never Sometimes Usually Almost always Always Menopause

Never Sometimes Usually Almost always Always Osteoporosis

Never Sometimes Usually Almost always Always Stress

Never Sometimes Usually Almost always Always Women/PMS

TOTAL SCORE:

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