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Psych Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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Insomnia
1
What is your gender?
Select one or more answers
Female
Male
2
What is your age?
Select one or more answers
18-21
22-24
24 and up
3
Do you struggle to sleep?
10- Every time 5- Once a month 1- Never
4
Do you tend to have all nighters on a regular basis?
10- Very often 5- At times 1- Nearly never
5
How badly does sleep deprivation effect your body?
10- Bad that I cannot function throughout the day 5- I'll be awake IF I drink an energy drink 1- I'll be fine
6
Please provide any feedback you would like to provide for this survey :)
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