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Are you
 
Male
 
Female
 
 
 
Do you have a school/job?
 
yes
 
no
 
 
 
Are you involved in any physical activities?
 
yes
 
no
 
 
 
On a scale of 1-10 how stressed are you 1 being least
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
 
 
How healthy is your diet? 1 being healthy
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
 
 
What age group are you in?
 
15-20
 
21-25
 
26-30
 
31-35
 
36-40
 
41-45
 
46-50
 
51-55
 
 
 
On a work/school day, how long do you sleep (Not including naps)?
 
1-6 hours
 
7-8 hours
 
9-12 hours
 
 
 
Do you feel tired throughout the day?
 
yes
 
no
 
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