Vitality MD

Mental Wellness Survey

    Decline in your feelings of general well-being?*
    (general state of health, subjective feeling)

    YesNoNot Sure

    Excessive sweating or hot flashes?

    YesNoNot Sure

    Increased need for sleep, often feeling tired?

    YesNoNot Sure

    Irritability? (feeling aggressive, easily upset about little things, moody)

    YesNoNot Sure

    Anxiety? (feeling panicky)

    YesNoNot Sure

    Depressive mood?
    (feeling down, sad, on the verge of tears, lack of drive, mood swings, feeling nothing is of any use)

    YesNoNot Sure

    Feeling that you have passed your peak?

    YesNoNot Sure

    Decrease in libido?

    YesNoNot Sure

    If you answered 4 or more call
    915-585-1300 for you consultation.