Please complete this questionnaire prior to your Individual Consultation.

    Personal Details

    Shipping Address

    Please provide the shipping address for receiving your herbs and supplies, which will be determined after your Individual Consultation.



    Assessment

    Take a moment to mark your choices to determine your Ayurvedic Constitution.

    Select the choices that are your tendencies over the span of your life (not what is true only recently, nor not who you want to be).

    Personality traits

    Reacts quickly, changes decisions easily, short term friendships (V)Dominating, inherently courageous, makes friends easily (P)Calm, quiet, patience, fortitude, stable personality, make friends slowly but lasts forever (K)

    Habits

    Difficult to create and sustain (V)Organized, make or break habits according to their utility (P)Difficult to begin (K)

    Concentration

    Difficult to concentrate, easily distracted (V)Intense focus ability, not long term (P)Sustained, long term focus (K)

    Quality of mind

    Quick, creative, imaginative but restless, original theorist (V)Sharp penetrating intellect, methodical, efficient planner (P)Stable, not flexible to changes (K)

    Memory

    Short term, notices easily, forgets easily (V)Sharp, clear (P)Good – long term (K)

    Reaction to stressful situation

    Fear or anxiety (V)Anger or irritability (P)Calm or avoids confrontation (K)

    Digestion

    Inconsistent, varies between weak and strong (V)Usually strong (P)Weak and slow (K)

    Appetite

    Variable (V)Strong, consistent, not comfortable skipping meals (P)Usually mild, can skip meals without discomfort (K)

    Bowel habits

    Irregular, dry stools (V)Two or more times a day, loose stool (P)Regular, once in a day, well formed (K)

    Sweating

    Scanty (V)Profuse with smell (P)Less (K)

    Sex drive

    Variable, think a lot about sex, often satisfied with fantasies, lower fertility (V)Ample drive, know they want, readily pull into action, average fertility (P)Steady desire, excellent fertility (K)

    Sleep

    Light, easily interrupted (V)Deep and uninterrupted (P)Deep and heavy (K)

    Types of Dreams

    Fear, flying, running, jumping, climbing trees and mountains (V)Anger, violence, struggle, war, fire, lightning, the sun, gold and light (P)Water, lakes, rivers, oceans, clouds, swans, flowers and romance (K)

    Speech

    Fast, omitting words and digressing (V)Fast, clear and precise (P)Slow, clear and sweet (K)

    Face

    Narrow and bony (V)Oval, angular, sharp features (P)Round, full (K)

    Complexion

    Dark, brownish or black (V)Fair, reddish (P)Light, clear and whitish (K)

    Body Weight

    Light, fluctuating, usually below normal (V)Average weight, can lose or gain easily (P)Can maintain moderate weight with regular exercise, easy to gain, difficult to lose (K)

    Body Frame

    Unusually tall or short, thin, narrow, shoulders/hips (V)Medium frame with moderately developed physique (P)Medium to broad, heavy boned, wide-set shoulders/hips (K)

    Build

    Thin, tall or short (V)Medium build and height (P)Heavy, large (K)

    Skin

    Thin, prone to dryness (V)Delicate and sensitive with freckles, moles (P)Soft, smooth, thick (K)

    Body Temperature

    Low, cold extremities (V)High, always feels warm (P)Low, body feels cool (K)

    Stamina

    Short (V)Moderate (P)Strong (K)

    Eyes

    Small, unsteady bulging or deep-set with scanty eyelashes, unclear white part (V)Sharp and penetrating with light colored lashes, reddish white part (P)Large, attractive with long thick lashes, clear white part (K)

    Teeth

    Small, protruding, crooked (V)Moderate size (P)Strong, large, white (K)

    Nails

    Short, rough, brittle, no luster (V)Slightly oily, pink (P)Full, thick, moist (K)

    Lips

    Dark, dry, thin (V)Soft, pink (P)Full, thick, moist (K)

    Fingers

    Very short or very long (V)Medium length (P)Short and stubby (K)

    Hair

    Thin, coarse, dry, wiry, darker in color (V)Thin, fine, soft, blonde or red, early graying (P)Thick, glossy, firmly rooted, wavy (K)

    Body Hair

    Scanty or abundant – variable (V)Moderate, light colored (P)Thick and plentiful (K)

    Joints

    Prominent, close to surface (V)Neither hidden or prominent (P)Deep and hidden (K)

    Tongue

    Dark, narrow, irregular (V)Pink or dark red, soft, sharp and long (P)Light colored, moist, symmetrical (K)

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