Could you benefit from Syntonics Light Therapy?
Choose a number from 0-5 that best represents the amount of difficulty, or the severity of the problem you tend to have for each item listed. Don’t dwell on any particular question. If you’re not sure, go with your gut feeling.
If it varies, indicate how bad a problem it can be. If you are successful at avoiding the problem, indicate how much difficulty you would have if you couldn’t avoid it.
0 = zero difficulty or problem
1 = slight difficulty or problem
2 = more than slight difficulty or problem 3=moderate difficulty or problem
4 = a lot of difficulty or problem
5 = severe difficulty or problem
1- BEHAVIORS
Do you have difficulties or problems with
- stress
- mental clarity
- maintaining your focus
- organizing your thoughts
- organizing your life
- change
- fatigue or lack of energy
- feeling frustrated or stuck
- feeling anxious
- feeling overwhelmed
- being easily startled
- hypersensitivity to sound or light
- feeling confused or fragmented
- memory or recall
- following directions
- little things that make you frus-trated or angry
- feeling frightened for no apparent reason
- irritability
- being overly sensitive or defensive
- being reactive: “reacting” instead of thoughtfully “responding”
- feeling impatient
- panic attacks
- excessive worry
- shallow breathing
- feeling disoriented
- feeling out of control
- feeling “frozen”
- being overly cautious or hyper-vigilant
- crying easily
- persistent or excessive sweating
- depression
- winter depression SAD (Seasonal Affective Disorder)
- seeing your options
- making decisions
- seeing the “big picture”
- getting a good night’s sleep
- TOTAL SECTION 1 :
2- DRIVING
Do you tend to be
- uncomfortable in heavy traffic?
- uncomfortable when changing lanes?
- sometimes surprised by cars around or behind you?
Do you tend to
- bump the curb or other cars while driving or parking?
- have trouble parking your car straight?
- have trouble judging distances when driving, parking, or passing other vehicles?
- find driving a task that requires effort and concentration, rather than relaxing?
- TOTAL SECTION 2 :
3- CONCENTRATION
- Do you find it difficult to concentrate on your job, schoolwork, or projects?
- Do you have any difficulty with concentration and/or comprehension when you read?
- Do you have eye fatigue that affects your job, schoolwork, or reading enjoyment?
- When concentrating, if distracted or interrupted, does it require effort to regain your concentration?
- Do you tend to procrastinate?
- Do you have difficulty starting projects?
- Do you have difficulty completing projects?
- Do you have difficulty multi-tasking, usually having to concentrate on tasks individually?
- TOTAL SECTION 3 :
4- ORIENTATION
- Do you tend to be uncomfortable in crowds and groups?
- Would you consider yourself “directionally challenged?”
- When you misplace something, do you frequently find it in a place you already looked?
- Do you sometimes have difficulty finding an item on a crowded supermarket shelf?
- Do you tend to bump into things, trip or miss a curb or stair, or bang your head when ducking under things?
- Do you sometimes feel or function as if you have tunnel vision?
- Do you tend to be a little clumsy?
- Do you experience motion sickness, nausea, or dizziness?
- TOTAL SECTION 4 :
5- LIGHTING
- Are you bothered by lights or glare?
- Do you have trouble with night vision or night driving?
- Do fluorescent lights bother you?
- TOTAL SECTION 5 :
6- PAIN
- Headaches: frequency?
- Headaches: severity?
- Other chronic physical pain: severity?
- TOTAL SECTION 6 :
7- TRAUMA
- Have you ever suffered any significant physical, mental, emotional, sexual, birth, medical, or other kind of trauma? (grade: 0=none to 5=severe)
- To what degree do you feel these traumas are still causing difficulties in your life today?
- TOTAL SECTION 7 :
8- STRESS
- On a scale of 1-10, what does your stress level tend to be, with ‘1’ being a laid-back beach bum and ’10’ being an air traffic controller who is the single mother of three?
- TOTAL SCORE :
How did you do?
There are a total of 350 points possible—most high-functioning individuals score fewer than fifty.
Many people even score thirty or fewer, some even fewer than ten.
If you scored over fifty points, please seriously consider how syntonic light therapy can improve not only your visual processing system but also your overall quality of life.