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How often do you feel unhappy?
Constantly
Often
Sometimes
Specific Situations
Do you feel unhappy in a specific environment or around specific people?
Yes
No
Just in General
Specific People or Places
How often do you exercise
Often
Sometimes
Not Often
Never
Have you ever been emotionally effected by a movie, story, etc?
Always
Most of the Time
Sometimes
Not Often
Never
Name
*
been a around
Email
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