Adult Mind Questionnaire - HomeopathicVibes

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Adult Mind Questionnaire

Why Me?

I'm providing homeopathic services for over 20 years in entire California. My clinic is located in Sunnyvale, Fremont, and San Jose. I have treated more than 1000 patients suffering from various conditions. I also provide online consultation if you're not able to visit any of my clinics. I have more than 100 five stars reviews on Google, Yelp, and other reviews websites. If you would like to know more about me, then feel free to reach me out by phone.

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Adult Mind Questionnaire

940 E. El Camino Real
Sunnyvale, CA 94087
harminder@homeopathicvibes.com
www.homeopathicvibes.com
Office Phone (408)737-7100
Office Fax (408)737-7102

Name *

First

Last

Email *

1. At home, work, or school, I find my mind wandering from tasks that are uninteresting or difficult.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

2. I find it difficult to read written material unless it is very interesting or very easy.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

3. Especially in groups, I find it hard to stay focused on what is being said in conversations.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

4. I have a quick temper... a short fuse.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

5. I am irritable, and get upset by minor annoyances.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

6. I say things without thinking, and later regret having said them.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

7. I make quick decisions without thinking enough about their possible bad results.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

8. My relationships with people are made difficult by my tendency to talk first and think later.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

9. My moods have highs and lows.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

10. I have trouble planning in what order to do a series of tasks or activities.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

11. I easily become upset.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

12. I seem to be thin skinned and many things upset me.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

13. I almost always am on the go.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

14. I am more comfortable when moving than when sitting still.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

15. In conversations, I start to answer questions before the questions have been fully asked?

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

16. I usually work on more than one project at a time, and fail to finish many of them.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

17. There is a lot of “static” or “chatter” in my head.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

18. Even when sitting quietly, I am usually moving my hands or feet.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

19. In group activities it is hard for me to wait my turn.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

20. My mind gets so cluttered that it is hard for it to function.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

21. My thoughts bounce around as if my mind is a pinball machine.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

22. My brain feels as if it is a television set with all the channels going at once.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

23. I am unable to stop daydreaming.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

24. I am distressed by the disorganized way my brain works.

Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

Message

About Me

I have passion for homeopathy. I am blessed to be born in family of Homeopaths. My grand father Dr. Hazara Singh Gill was great homeopath of his times. He did his M.B.H (Bachelor of Medicine in Homeopathy) from Punjab Homeopathic Medical College Lahore in 1925.

Sunnyvale Location

Phone: 408-737-7100
Fax: 408-737-7102
Address: 940 E El Camino Real, Sunnyvale, CA 94087, United States
harminder@homeopathicvibes.com

Fremont Location

Phone: 408-737-7100
Fax: 408-737-7102
Address: 39039 Paseo Padere Parkway,Suite #209,Fremont, CA 94538, USA.
harminder@homeopathicvibes.com

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