Complete Your Intake
Welcome
We're looking forward to welcoming you to Axia.
Before your first visit, please complete the five steps below. As part of the intake, you'll complete three standardized brain questionnaires: the Van Deusen, Amen, and Attention questionnaires. Because each was developed for a different purpose, you may notice some overlapping questions. This is intentional. Together, they provide a more comprehensive picture of your brain's functioning and are submitted as part of the data used to generate your personalized report and recommendations. Your responses help us understand your health history, goals, and current brain performance so we can tailor your assessment and recommendations to your unique needs.
The entire process takes approximately 30–60 minutes to complete. For the best experience, please submit all forms at least 48 hours before your appointment.
Once you've completed all five steps, you're all set. We'll review everything in advance so we can make the most of our time together during your visit.
If you have any questions before your appointment, we're here to help.
Step One
Demographics
Provide your contact information, emergency contact, and basic background information. This helps us prepare your client file before your visit.
Estimated time: 5-10 minutes
Step Two
Van Deusen Questionnaire
This standardized questionnaire explores patterns related to brain function, mood, behavior, and cognitive performance. Your responses contribute to your personalized assessment and report.
Estimated time: 8-10 minutes
Step Three
Amen Questionnaire
This questionnaire provides additional insight into brain health and functioning from a different clinical perspective. Some questions may overlap with other questionnaires, which is a normal and intentional part of the assessment process.
Estimated time: 8–10 minutes
Step Four
Attention Questionnaire
This screening questionnaire helps us evaluate attention, focus, executive functioning, and related symptoms. It is completed by all clients, regardless of whether ADHD is a primary concern.
Estimated time: 5–7 minutes
Step Five
Informed Consent
Review important information about neurofeedback, clinic policies, and your rights as a client before electronically signing the consent form.
Estimated time: 3–5 minutes
Thank You
Thank you for taking the time to complete your intake. Your responses help us better understand your unique brain and ensure your first visit is personalized, efficient, and meaningful.
We're honored to be part of your journey and look forward to welcoming you soon.