Symptom Survey
Choose which of the following symptoms best reflect your current condition
How do you feel when you wake up?
How difficult is it for you to start your day?
Do you need Coffee to start your day?
Do you workout before you go to work?
Do you have a hard time falling asleep?
Can we contact you for more questions?
These elements are built with default input checkboxes.
Easy to use for your programatic functions.