What is your most common migraine trigger? *

Emotional stress or disrupted sleep

Certain foods like wine, cheese, or histamine-rich items

Hot weather, altitude, or hormonal changes

Skipping meals or intense physical activity

Which of these other health issues have you dealt with? (check all that apply)

Chronic fatigue, fibromyalgia, or post-viral crashes

Raynaud’s, low blood pressure, or hormonal migraines

IBS, eczema, or seasonal allergies

Anxiety, depression, or ADHD

What best describes your pain? *

Pressure, sinus-like, or pain triggered by food or gut issues

Tight, tension-like with sensitivity to noise or emotions

Fatigue-related, often after travel, fasting, or physical effort

Throbbing, one-sided, often with visual aura

Have any of these supplements helped you? (Skip this one if you have not tried supplements)

Fish oil or magnesium glycinate

5-HTP, or adaptogens like ashwagandha

Turmeric, quercetin, or probiotics

CoQ10 or riboflavin

What happens when you’re in a high-stress situation? *

I flare up physically (inflammation, gut, skin)

I feel completely drained, like I’m running on empty

I get overwhelmed or emotionally reactive

My blood pressure spikes or I get hot and flushed

What describes your energy pattern on most days? *

Pretty good unless the weather or hormones shift

Low energy overall, especially after exertion

Variable with bursts of energy and then fatigue

Sluggish after meals or when inflamed

How does alcohol affect you (if applicable, otherwise skip)

I get sinus issues, headaches, or skin flushing

It disrupts my sleep or worsens my mood

Immediate pounding headache or blood pressure issues

I feel wiped out and foggy the next day

How do you recover after a workout? *

Completely drained or headachy for hours or days

Emotionally uplifted, unless I’m stressed

Exercise can trigger a migraine

Sore, inflamed, or bloated

Do you have any of these sleep issues? (Skip this one if your sleep is great)

Restless—I feel inflamed or congested if I eat poorly before bed

Sensitive—I have trouble falling asleep or staying asleep

I sleep long but wake unrefreshed and foggy

I often wake with a pounding headache or feel worse if I oversleep

First Name *

Email *

You’ll see your results on the next page, and I’ll send you a free copy of my eBook, "Your Genetic Migraine Type: Unlocking the Code to Fewer Attacks (a $9.97 value)