Sticky Mobile

### Symptom Survey

Choose which of the following symptoms best reflect your current condition

##### How do you feel when you wake up?

Bad
Neutral
Good

##### How difficult is it for you to start your day?

Easy
Medium
Difficult

##### Do you need Coffee to start your day?

Yes
Sometimes
Nope

##### Do you workout before you go to work?

No
Sometimes
Yes

##### Do you have a hard time falling asleep?

No
Sometimes
Yes

##### Can we contact you for more questions?

Yes.
No.
Submit Results

These elements are built with default input checkboxes.
Easy to use for your programatic functions.