Assesment and Consultant Form

Our constitution is the inherent balance of energies within our bodies and our minds. It describes who you are on the most fundamental level. By understanding your own unique nature or constitution you can begin to understand how you interact with your environment and thus make choices that will lead you toward greater health. Ayurveda shows that the path to optimal health is different for each person depending upon their constitution. To help identify your constitution please read the questions below and try to answer them to the best of your knowledge. (Please tick the right one)
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Name : *
Age :*
Weight :*
Height :*
Email : *
Country :
Sex: Male Female
Your skin texture is :Dry and Rough Warm, Oily Pale and cold
Your hair are :Dry and thin Thin and Oily Thick and oily
Your teeth are :Poorly formed Moderate, bleeding gums Large
Your nails :Small and nervous  Yellowish, Red Large, White
Your eyes :Rough and brittle  Soft and pink Soft and white
Your thirst :Low High Moderate
Your stool :Hard and dry Soft and loose Normal
Your activity:Very active Medium Low
Your sleep :Poor and disturbed  Medium Excess
Your memory :Quick, forget easily  Sharp and clear Slow but steady
Decision taking Capacity:Nervous Very clear Medium
Sexually you are :Nervous dominant Strong
You tend to develop gas or constipationYes No
You prone to cold hand and feet Yes No
You frequently anxious & worried Yes No
You like cold weather Yes No
Your mood changes easily Yes No
You are easily excitable Yes No
You consider yourself very efficient Yes No
You are very discipline & precise In your work Yes No