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Instructions

1. Make sure you are in a well-lit room

2. Position your eyes in the camera so both your pupils are clear and visible

3. Take the questionnaire below and await the results

Concussion Questionnaire

Headaches

Thank you for submitting your answers!

Nausea/Vomitting
Fatigue
Light/Noise Sensitivity
Feeling Depressed/Irritable
Feeling Forgetful
Poor Concentration
Blurred/Double
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