Ayurvedic Assessment Questionnaire

 

 

Name __________________________________                 Date __________

 

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

 

Circle the choices, that are your tendencies over the span of your life (not what is true recently or not who you want to be).

 

 

  1. Physique
    1. V) I am a slender person (size 0 – 6) and I hardly gain weight
    2. P) I am medium built (size 8-10)
    3. K) I am well built (size 12-+) and I gain weight no matter what I do

 

  1. Weight
    1. V) I am light weight, if I gained weight, I can easily shed those pounds off
    2. P) I am medium weight, good muscles, do not gain weight easily.
    3. K) I tend to gain in pounds and lose in ounces

 

  1. Skin
    1. V) My skin is dry, thin, and itches often
    2. P) My skin looks flushed; I have lots of moles and freckles on my body
    3. K) My skin is smooth and soft, it looks pale sometimes

 

  1. Hair
    1. V) My hair is thin, dry and brittle
    2. P) I am blond, brunet, I have receding hairline
    3. K) My hair is thick, full, lustrous, and slightly oily

 

  1. Face
    1. V) My face is oval
    2. P) My face is triangular (I have a pointed chin/prominent jaw line)
    3. K) My face is round

 

  1. Eyes
    1. V) My eyes are small; they feel dry and unsteady often 
    2. P) My eyes are medium in shape, sharp and penetrating
    3. K) My eyes are big and round in shape

 

  1. Hands
    1. V) My hands are small, generally Dry, Rough
    2. P) My hands are generally Moist, Pink
    3. K) My hands are generally Firm, Thick
  2. Fingers
    1. V) My fingers are long, Thin and narrow
    2. P) My fingers are medium, pointed
    3. K) My fingers are large, stocky fingers

 

  1. Complexion
    1. V) My skin is dull, darkish
    2. P) My skin is red, ruddy, glowing
    3. K) My skin is white, pale

 

  1. Joints
    1. V) My joints are small, may crack
    2. P) My joints are medium, loose
    3. K) My joints are large, deep seated (I have lot of muscles around my joints)

 

  1. Activities
    1. V) I am very active person (Always on the go)
    2. P) I like to think before I do anything
    3. K) I am steady and graceful (I don’t like to rush)

 

  1. Actions
    1. V) I walk fast and talk fast (drive in the fast lane)
    2. P) My actions are very thoughtful, and precise (drive in the middle lane)
    3. K) I like slower pace – I take my time to do things (drive in the right lane)

 

  1. Sleep
    1. V) I do not sleep soundly at night, I toss and turn I awaken early in the morning
    2. P) I am a light sleeper, if something wakes me up, I can easily go back to     sleep
    3. K) I am a heavy sleeper (I sleep like a log)

 

  1. Appetite
    1. V) Varies, sometimes I feel hungry, some times not, often I feel anxious if I don’t eat
    2. P) I always feel hungry; if I don’t eat, I get irritable and angry
    3. K) I don’t feel very hungry; I can go without food easily for a day

 

  1. Bowel movement
    1. V) I tend to have constipation, and can go a day or two without a bowel

movement

    1. P) Regular bowel movements and some times they are loose
    2. K) I have no problem; I wake up to go to the bathroom

 


  1. Voice
    1. V) My voice tends to be weak, hoarse
    2. P) I have a strong voice, I may get loud sometimes
    3. K) My voice is deep, has a good tone

 

  1. Speech
    1. V) I am very talkative, I can’t keep quiet, I am a storyteller
    2. P) I speak very clearly, to the point, never beat around the bush
    3. K) I take time before I start speaking, I am not very clear about what I want to   say,  I am good listener not talker

 

  1. Emotions
    1. V) I am a born worrier, I often feel anxious and nervous
    2. P) If things don’t happen my way, I feel very irritable and angry
    3. K) I am a happy person, very caring and loving

 

  1. Weather preference
    1. V) I love warm and humid weather
    2. P) I enjoy cool weather, I hate warm climate
    3. K) I like warm but dry weather

 

  1. Sweating
    1. V) I hardly sweat
    2. P) I perspire very easily
    3. K) I sweat only if I work very hard

 

  1. Memory
    1. V) I remember quickly, but forget quickly too
    2. P) I remember what I want to remember, and never forget
    3. K) I am a little slow to remember, but once I do, I never forget. I remember minor Details

 

  1. Actions
    1. V) I tend to be spontaneous, I do things first and then think
    2. P) I am a list maker, unless I plan, I don’t do anything
    3. K) I don’t like to plan, I prefer to follow others

 

  1. Hobbies
    1. V) I like art (drawing, painting, dance) and travel
    2. P) I like Sports, politics, and things that gets my adrenaline pumping
    3. K) I am a nature person; I like gardening, reading, and knitting

 


  1. Mind
    1. V) My mind gets restless easily (it starts racing)
    2. P) I get impatient easily
    3. K) It takes alot, to make me mad. I usually feel very calm

 

  1. Decision making
    1. V) I change my mind often
    2. P) I can easily take a decision, and stick to it
    3. K) I prefer others to take decisions, I’m more comfortable letting others lead

 

  1. Personality
    1. V) “Can I change my mind”?
    2. P) “It’s my way or the highway”
    3. K) “Don’t worry, be happy”

 

  1. Sports
    1. V) I like action
    2. P) I like to win (Winning is not everything, winning is the only thing)
    3. K) I like to have fun

 

  1. Stamina
    1. V) I like to do things in spurts and get tired very easily
    2. P) I have medium stamina
    3. K) I keep going and going and going -I can work long hours and have a good stamina

 

  1. Resistance to Disease
    1. V) I fall sick often, I have weak immune system
    2. P) I have medium resistance
    3. K) I have strong immune system, I hardly get sick

 

  1. Health problems
    1. V) Often I suffer from constipation, anxiety and depression, pain, fatigue
    2. P) I often get skin infections, fevers, and heartburn
    3. K) I tend to get allergies, congestion, weight gain and digestive problems

 

 

Total          V _____          P ______         K ________