Survey I: Please fill out this form prior to following any of our suggested action steps. This will aid us in our compilation of data for research. Thank you!!

Survey I: Please fill out this form prior to following any of our suggested action steps. This will aid us in our compilation of data for research. Thank you!!

Are your male or female? *
What is your age? *
What was your age when you had your first migraine? *
How many years have you had migraine headaches? *
Have your headaches been formally diagnosed by a physician? *	Yes No
If 'yes' above, what type of migraine did your physician diagnose you with? *
Have you tried prescription treatments? *	Yes No
If 'yes' to the previous question, please list the drugs you have tried and your response to them. If 'no' to the previous question please put N/A here. *
Approximately how many migraines do you have per month? *
Do your migraine attacks include a prodrome or aura? *	Yes No
If you do suffer from a prodrome or aura, please describe your symptoms. If not put NA *
How long, in hours, does your typical migraine last from prodrome to the stop of the headache? *
Do you eat fast food? *	Yes No
Do you eat processed foods (boxes, cans, from grocery store)? *	Yes No
Do you exercise? *	Yes No
Do you take an omega supplement? *	Yes No
Do you have regular bowel movements? *	Yes No
How often do you have a normal bowel movement? *
Describe your stress level as low, medium, or high. *
Do you have back or neck pain? *	Yes No
Do you consider yourself to have good/proper posture? *	Yes No