Brain Health Pre-Post Quiz Form
Complete this brain health quiz as a pre-quiz or post-quiz check-in. Keep answers aligned with the same form title and do not include any sensitive health information.
Quiz Details
Participant Name or Identifier
Age Group
*
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to say
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Quiz Timing
*
Pre-quiz
Post-quiz
Brain Health Quiz
Which habit most supports overall brain health?
*
Regular physical activity
Getting enough sleep
Eating a balanced diet
All of the above
Which actions can help support healthy brain function?
*
Staying hydrated
Doing regular exercise
Getting enough sleep
Managing stress
Skipping meals
How much sleep is generally recommended for most adults each night?
*
Less than 5 hours
5 to 6 hours
7 to 9 hours
10 or more hours
Brain health knowledge check
*
Rows
True
False
Hydration can affect attention and concentration.
1
2
Regular movement may support brain health.
3
4
Stress management can help cognitive performance.
5
6
Skipping sleep improves memory.
7
8
Quiz Reflection
How confident are you in your brain health knowledge?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Optional note or takeaway
Submit Quiz
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