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Q1. Which of these best describes your physical frame?
Q1A. Long and narrow. I am smaller and have thin bones. It can be hard to gain weight.
Q1B. Average. I have medium bones. I gain and lose weight more easily.
Q1C. Heavy or stocky. I have larger bones. It's a challenge to lose weight.
Q2. Which of these best describes you walking and speech pattern.
Q2A. Fast-paced. I'm quick and always on the go.
Q2B. Moderate pace. I am sharp and concise.
Q2C. Slow. I'm usually calm and mellow
Q3. Which of these best describes your patterns about how you sweat?
Q3A. I sweat very little, often with little to no body odor.
Q3B. I sweat a lot, with a fair amount of body odor.
Q3C. I sweat moderately, with quite strong body odor.
Q4. Which of these best describes your preferences about weather?
Q4A. I prefer hot weather.
Q4B. I prefer cool weather.
Q4C. I am adaptable, but I don't like cold, wet weather.
Q5: Which of these best describes your skin?
Q5A. My skin tends to be normal to dry, rough, thin, and cool. It's hard to keep moisturized.
Q5B. My skin tends to be normal to oily, sensitive, warm and soft. I can be prone to redness, itchiness, or inflammation.
Q5C. My skin tends to be smooth, thick, and slightly oily.
Q6. Which of these best describes your teeth and lips?
Q6A. I have uneven teeth and/or thin lips that often are dry.
Q6B. I have teeth with cavities and are medium in size. I have soft lips.
Q6C. I have strong, even teeth. I have full lips.
Q7. Which of these best describes your eyes?
Q7A. I have smaller eyes. They tend to be dry, and I am often blinking.
Q7B. I have mid-sized eyes. They tend to be red.
Q7C. I have large eyes. They are pretty and attractive.
Q8. Which of these best describes your appetite?
Q8A. It's uneven. I may skip meals due to no hunger or not being aware when I am hungry. Sometimes I have low energy and/or headaches. Sometimes I cannot focus.
Q8B. It's strong. I'm usually hungry. I get irritable if I wait too long to eat.
Q8C. It's slow and weak. I may reach for food to soothe emotions even if I'm not hungry
Q9. Which of these best describes your hair?
Q9A. Dry, rough, wavy.
Q9B. Straight, think, oily. My hair has a reddish tint.
Q9C. Curly, thick, oily.
Q10. Which of these sounds most like your body?
Q10A. My joints make cracking sounds. My nails easilly crack. I have a small forehead.
Q10B. I have moles on my body. My nails are soft and pink. My forehead is medium in size.
Q10C. My body size is heavier such as larger bones and well-padded joints. I have a large forehead relative to my body. I have wide, whitish nails. Sometimes I have issues with congestion or colds.
Q11. When I'm out of balance, my mind is:
Q11A. Restless, spacey, and scattered. It's hard to make a decision.
Q11B. Impatient, irritable. I can be aggressive or uncompromising of self and others.
Q11C. Sluggish, with a lack of clarity. Foggy.
Q12. When my mind is in action, it's most like
Q12A. Adaptable to change, dislikes repetition. Sometimes I overthink things.
Q12B. Quick-thinking. I can implement things pretty fast. I am focused, driven, and bright.
Q12C. Calm, loyal, and steady. Sometimes, though, I may put off doing things. I can be a procrastinator.
Q13. We all have times when we feel emotionally out of balance. Which of these best describes you?
Q13A. I worry often. I can feel fearful - and lonely.
Q13B. I am easily irritable. I can be impatient, jealous, or angry.
Q13C. Lethargy, depression, lack of motivation.
Q14. Which of these best describes how your memory works?
Q14A. I learn fast but easily forget.
Q14B. I learn at a medium pace. I retain learning. I'm studious and sharp intellectually.
Q14C. I learn at a slow speed, but when I learn it, I retain it well.
Q15. Which of these best describes the quality of your sleep?
Q15A. I am easily disturbed. My sleep is quite light, and I get fewer hours of sleep.
Q15B. I am regular and consistent about getting an average length of sleep. But it can get reduced when I'm active in thought or physical activity.
Q15C. I sleep heavy and deep. I prefer long hours of sleep. It's hard to wake up.
Q16. Which of these best describe your body temperature regulation?
Q16A. My hands and feet are usually cold to the touch. I prefer hot weather.
Q16B. My hands and feet are warm to the touch. I prefer a cooler climate.
Q16C. My hands and feet are clammy to the touch. Yet sometimes I am not aware when I need to make a choice to keep a certain body temperature.
Q17. Which of these best describes your stamina?
Q17A. I am easily exhausted. At times I can be delicate.
Q17B. I have a strong will and moderate energy. I can push if need be.
Q17C. I have great endurance, but I'm not too motivated.
Q18. Which of these best describes you as a child or young adult?
Q18A. I was excitable, creative, and enthusiastic with a good imagination.
Q18B. Wise, disciplined, smart, ambitious.
Q18C. Warm, compassionate, gentle with a loving nature.
Q19. What is your activity level?
Q19A. Fast-paced. Sometimes it's hard to relax. I enjoy travel and adventure.
Q19B. Competitive. I enjoy intellectual and physical activities.
Q19C. I prefer to relax rather than be active.
Q20. Which of these digestive items is more likely to come up for you?
Q20A. Gas and/or bloating
Q20B. Stomach discomfort with indigestion or acidity; heartburn
Q20C. Sluggish digestion with a heaviness; water retention
Q21. Which best describes your mental speed and activity?
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Q21a. My mind races quickly, full of ideas, sometimes hard to focus.
Q21b. My mind is sharp, focused, and analytical - sometimes intense.
Q21c. My mind is steady, calm, but sometimes slow to get moving.
Q22. With regards to your memory, what describes you best?
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Q22a. Quick to learn, quick to forget.
Q22b. Good memory, especialy for details.
Q22c. SLow to learn, but once learned, never forgotten.
Q23. Tell me about your mood
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Q23a. Being spontaneous and charming, I am quite lively. I thrive on change.
Q23b. Being intense with a purpose, I can be quite convincing
Q23c. Calm, compassionate, easygoing but like routine. A nurturer. I love to support others but may ignore my own needs.
Q24. When you are under pressure, how do you react?
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Q24a. I feel scattered and overwhelmed. Anxious. I am forgetful. It is easy to blame myself. I am not hungry.
Q24b. I become driven, intense, or controlling. I am impatient and irritable with myself and others. I want it my way with the bar being pretty high.
Q24c. I tend to procrastinate, avoice, or shut down. I prefer to hibernate. Blaming myself, I won't say anything. I pretend to be fine. I eat to feel better.
Q25. How would you describe your social connections?
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Q25a. I can be easily distracted. I am often late for appts. I am ok if others are late, especially my many friends.
Q25b. I am on time and even early. It upsets me if others are late. I have fewer friends.
Q25c. Running late is more my style. I move slower. I may spend too much time thinking about a problem that may cause me to be late. I have patience. Many friends are present with some of them not supportive of me.
Q26. What is your home environment like?
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Q26a. My home is filled with sunshine. I am more of a minimalist. I prefer color with good function present.
Q26b. Needing a neat home, I prefer to have high quality home goods and artwork. This is true for clothing and electronics as well.
Q26c. Being a nester, I have clutter, and it is ok. I keep things beyond their shelf life. I can feel attached.
What is one thing you'd like to change about your wellness habits, and why? (You are not required to answer this question.)
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