Please help us to help you more by taking 30 seconds out of your day to answer these important questions.

Please answer these questions BEFORE you start your SleepDrops Menopauzzz™ remedy
If you have already started please answer them from your most accurate memory about how things were for you.

Name*
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ON a scale of 1 to 10 1 being not bad and 10 being bad How would your rate your sleep?
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ON a scale of 1 to 10 1 being not so bad and 10 really bad How would your rate your ability to fall asleep recently?
1 2 3 4 5 6 7 8 9 10
On average how long does it take you to fall asleep?
ON a scale of 1 to 10 1 being not so bad and 10 really bad How would your rate your waking through the night?
1 2 3 4 5 6 7 8 9 10
ON average how many times a night do you wake?
On average how long are you awake?
ON a scale of 1 to 10 1 being not so bad and 10 really bad How would your rate your hot flushes at night?
1 2 3 4 5 6 7 8 9 10
ON a scale of 1 to 10 1 being not so bad and 10 really bad How would your rate your hot flushes during the day?
1 2 3 4 5 6 7 8 9 10
ON a scale of 1 to 10 1 being not so bad and 10 really bad How would your rate your night sweats?
1 2 3 4 5 6 7 8 9 10
ON a scale of 1 to 10 1 being bad and 10 AWESOME How would your rate your energy when you wake up?
1 2 3 4 5 6 7 8 9 10
ON a scale of 1 to 10 1 being bad and 10 AWESOME How would your rate your energy throughout the day?
1 2 3 4 5 6 7 8 9 10
ON a scale of 1 to 10 1 being good and 10 VERY BAD How would your rate your anxiety during the day?
1 2 3 4 5 6 7 8 9 10
ON a scale of 1 to 10 1 being good and 10 VERY BAD How would your rate your anxiety during the night?
1 2 3 4 5 6 7 8 9 10
Is there anything you would like to share with us about how your menopause journey is affecting you?