Name *Email Address *Phone *Welcome to BHERI!Thank you for your participation! We serve a community of veterans who sustained traumatic brain injuries (TBI) by providing them with research-backed nutrition to support brain function and healing. We are looking to expand our community to include current and former athletes, high risk workers, and others who have had a TBI (yes, this includes concussions!). Please rate each symptom below on a scale of 0-6 (0= non-existent, 6= prohibits my work/daily routine).HeadachesDizziness, Loss of Balance, Coordination ProblemsVision Problems, Blurred Vision or Trouble SeeingLight SensitivityHearing Difficulty, Sensitivity to NoiseRinging in the EarsPressure in HeadNot Able to Think Clearly / Feeling Mentally FoggyProblems with Confusion / Easily ConfusedFeeling Depressed or SadEmotional WithdrawlFeeling Anxious or Tense / NervousnessIrritability, Easily Annoyed, Hostility, Temper OutburstsFeeling Easily Overwhelmed by ThingsFeeling More EmotionalFatigue, Loss of Energy, Getting Tired Easily, DrowsinessDifficulty Concentrating, Can't Pay Attention, Easily DistractedDifficulty Remembering, Forgetfulness, Memory ConcernsDifficulty Making DecisionsReadingInsomnia, Difficulty Falling Asleep or Staying AsleepDo your symptoms worsen with physical activity?YesNoDo your symptoms worsen with mental activity?YesNoIf you performed at 100% before your injury (or most recent injury), at what percentage do you perform now?Please describe the nature of your injury. (If you have sustained multiple injuries, focus on the most recent one.)Send Message
