Body Alignment Session

Hi yogi!

This is a confidential record of your wellness history and will be kept in this office. Information that you share in this questionnaire will not be shared unless you have authorised me to do so. Please completely this questionnaire as thoroughly as possible.

Thank you : )


To start, please fill in your order number

Click here to get started!

About you

Step 3: Personal Health Habits and Details you

Personal Health Habits and Details

Step 4: Daily Rhythms history

Daily Rhythms

Morning: 6 - 10 am

Midday 10 am - 2 pm

Afternoon 2 pm - 6 pm

Evening 6 pm - 10 pm

Step 5: Eating habits

Eating Habits

Step 6: Sleep habits

Sleep habits

Step 7: DOSHA Quiz

DOSHA Quiz

In each row, choose the characteristic that most applies to you and fill in the amount of characteristics under V, P and K at the bottom of this page. If there are two characteristics that are equally present in your body or mind, count both.

Important

Please answer this about your whole life, not the last couple of months or weeks. Be very honest with your answers and select the one that is the real you.

V
Frame I am thin, lanky & slender with prominent joints & thin muscles
Weight low, I may forget to eat or have the tendency to lose weight
Eyes my eyes are small and active
Complexion my skin is dry, rough or thin
Hair dry, brittle or frizzy
Joints my joints are thin and prominent and have a tendency to crack
Sleep pattern I am a light sleeper with the tendency to awaken easily
Body temperature my hands and feet are usually cold and I prefer warm environments
Temperament I am lively and enthusiastic by nature, I like to change
Under stress I become anxious and/or worried
Result
P
Frame I have a medium symmetrical build with good muscle development
Weight moderate, it is easy for me to gain or lose weight if I put my mind to it
Eyes I have a penetrating gaze
Complexion my skin is warm, reddish and prone to irritation
Hair fine with tendency towards early thinning or greying
Joints my joints are loose and flexible
Sleep pattern I am a moderately sound sleeper, needing less than 8 hours to be rested
Body temperature I am usually warm, regardless of the season, and prefer cooler environments
Temperament I am purposeful and intense, I like to convince others
Under stress I become irritable and/or aggressive
Result
K
Frame I have a large, round or stocky build, my frame is broad or thick
Weight heavy, I gain weight easily & have difficulty losing it
Eyes I have large pleasant eyes
Complexion my skin is thick, moist and smooth
Hair I have abundant, thick and oily hair
Joints my joints are large, well knit and padded
Sleep pattern my sleep is deep and long, I tend to awaken slowly in the morning
Body temperature I am adaptable to most temperatures but do not like cold, wet days
Temperament I am easy going and accepting, I like to support
Under stress I become withdrawn and/or reclusive
Result
Step 8: Over the past few weeks...

Over the past few weeks






























That's it!

This is the end of the questionnaire. Hit the button below to send : ).