Who are you taking this assessment for?
Myself
A Sibling
A Parent
A Different Loved One
How long have you been suffering from depression?
Less than 2 weeks
1 - 6 months
6 - 12 months
1 - 2 years
2 - 4 years
More than 4 years
How did you hear about 's non-invasive TMS therapy?
Dr. Oz
The Doctors
Facebook / Google
Radio
Have you ever been diagnosed with bipolar, schizophrenia, or other psychotic illnesses?
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Yes
No
How many antidepressant medications have you tried?
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None
1 - 2 medications
3 - 4 medications
4 or more medications
Have you tried counseling?
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Yes, I have tried it and failed
Yes, but I stopped going because it wasn't working / I didn't like it
No, I have never tried it
Has your doctor ever used medications other than antidepressants to help you feel better?
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Yes, I have tried Xanax, Abilify, Adderall, Lamictal, or other medications
No, I have only tried antidepressants
Please Tell Us About Yourself
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Male
Female
Age
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18-24
25-49
50-64
65 & Older
Which insurance do you have?
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Aetna
BCBS
Medicare
Medicaid
Other
I do not have insurance
How soon are you looking to take care of your depression?
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Right now!
As soon as possible
This week
This month
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