TBI Testing

Which of These Physical Symptoms Are You Experiencing?

Please Select All That Apply*

Loss of ConsciousnessFatigue or DrowsinessSleeping More Than UsualDizziness or Loss of BalanceDilation of One or Both PupilsLoss of CoordinationNausea or VomitingConvulsions or SeizuresDifficulty SleepingInability to Wake From SleepNumbness in Fingers or ToesPersistent or Worsening HeadacheNoneOther

Which of These Sensory Symptoms Are You Experiencing?

Please Select All That Apply*

Blurred VisionSensitivity to LightBad Taste in MouthRinging in EarsChanging in Ability to SmellSensitivity to SoundNone

Which of These Cognitive or Mental Symptoms Are You Experiencing?

Please Select All That Apply*

Problem w/ MemoryConcentration ProblemsMood Changes or SwingsSlurred SpeechFeeling Anxious or DepressedComaConsciousness DisorderNO SYMPTOMS