TMS Survey

Self Assessment Quiz

Are you a candidate for TMS?

Part 1/3

Are you looking for a non medication treatment option? **

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Have you tried medications and not gotten relief? **

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Do you experience concerning or uncomfortable side effects from medications? **

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Part 2/3

Do you feel like you’ve tried everything to get improvement and nothing has worked? **

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Are you concerned about cognitive decline or been told that you have Mild Cognitive Impairment (MCI)? **

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Part 3/3: Your Information

First Name**

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Last Name**

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Email**

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Phone

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Text Messaging

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