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Sleep Pre-Study Questions
Please fill out this survey to the best of your ability so that we can obtain an accurate reading of how you're feeling before the study begins.
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* Indicates required question
Who invited you to join this oil study?
*
Your answer
Name
*
Your answer
Full Address to mail samples
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
How often do you struggle with sleep?
*
Almost Never
Sometimes
Almost Always
Always
What type(s) of sleep problems do you experience? (ex: falling asleep, staying asleep, restful sleep, etc.)
*
Your answer
On average how many hours of sleep do you get per night?
*
1
2
3
4
5
6
7
8
How long has this been a problem?
*
Less than 1 year
1-3 years
3-7 years
7+ years
How ready are you for this to change?
*
Not very ready
Somewhat ready
Very ready
Do you currently have a doTERRA membership?
*
Yes
No
I am not sure
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