Name
Email Address
Is your skin...
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Is your complexion*...

(*Take into consideration that in every ethnic group there is a natural range of shades and textures, some attributes may not apply to you)

…bluish?
…red, ruddy or yellowish?
…pale
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Is your hair*...

(*Take into consideration that in every ethnic group there is a natural range of shades and textures, some attributes may not apply to you)
…dry, brittle, thin or coarse, brown, black?
…fine and straight, blond, red, graying early or balding?
 …oily, thick, luxuriant, wavy curly, dark?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Are you eyes…

 
…small, nervous, dry, black or brown?
…sharp, bright, sensitive to light, grey or green, with a penetrating gaze?
 …big, calm, blue with a loving gaze?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Are your teeth...
…big, crooked or protruding, healthy with thin, receding gums?
…medium-sized, yellowish and soft, with tender gums?
 …strong and white with healthy gums?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Are your lips…

 
…dry, thin, dark red, or yellowish?
…soft, pink, and firm, pale?
 …oily and smooth, large, thick?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Is your bone structure…

 
…slim, slight, prominent?
…medium?
 …thick, solid, heavy?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

Is your height...

…above or below average?
…average?
 …average or tall?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are your muscles…
…wiry, underdeveloped?
…moderately developed?
 …solid, stocky, well-developed?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your weight...
…below average, you lose weight easily?
…medium, able to lose or gain weight?
 …above average, you gain weight easily?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is most of your fat...
…around the waist?
…evenly over the body?
 …around the hips and thighs?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are your veins...
…prominent?
…somewhat visible?
 …not visible?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is most your hair...
…dry, brittle, thin or coarse, brown, black?
…fine and straight, blond, red, graying early or balding?
 …oily, thick, luxuriant, wavy curly, dark?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are your shoulders...
…narrow and slope downward?
…medium size?
 …broad, firm, well-developed?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are your hips…
…narrow?
…medium width?
 …wide?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are your hands…
…small, dry, cool, with thin, long fingers?
…medium-sized, moist, warm, pink?
 …large, oily, cool, firm?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are your nails…
…dry, rough, brittle, and break easily?
…flexible, pink and lustrous?
 …thick, smooth, shiny and hard?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your perspiration…
…scanty, with no odor?
…heavy with a strong odor?
 …moderate or heavy with a pleasant odor?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your lifestyle…
…highly active?
…active?
 …rather inactive?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your appetite...
…irregular, with skipped meals?
…strong, must eat regular meals?
 …constant, but can skip meals?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your sleep pattern...
…irregular, light, interrupted, 5-7 hours a night?
…sound and even, 6-8 hours a night?
 …prolonged and deep, difficult to wake up?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your gait...
…quick, short steps?
…medium pace, purposeful?
 …slow and graceful?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your energy or endurance...
…low, your energy comes in spurts, then you need to rest?
…well managed?
 …good, long lasting?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your speech pattern...
…fast, talkative?
…precise, convincing?
 …slow, monotone, melodic?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is the pace of your activity...
…fast?
…medium speed, intense?
 …slow, steady?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your sex drive...
…either in very high or very low gear?
…moderate frequency, but passionate and domineering?
 …infrequent, constant or cyclic, loyal and devoted?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Do you dislike weather that is...
…cold, windy, dry?
…hot, with strong sun?
 …cool and damp?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Are you...
…flexible, optimistic, lively, intuitive, enthusiastic, changeable, an initiator?
…ambitious, practical, intense, motivated, perceptive, warm, friendly, independent, courageous, discriminating, a good leader, goal-orientated, competitive?
 …calm, peaceful, solicitous, resilient, content, loyal, slow, deliberate, relaxed, compassionate, patient, nurturing, stable?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your memory...
…quick to remember--and to forget?
…average, clear distinct?
 …slow to remember--and slow to forget?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your thinking style...
…restless, quick?
…organized, efficient, accurate?
 …slow, methodical, exacting?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Do you process information...
…quickly?
…at medium speed?
 …slowly?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Is your creativity level...
…filled with ideas, but tend to follow through poorly?
…inventive in many areas, with good follow-through?
 …best in the field of business?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Under stress you do you become...
…anxious, insecure, tense and sigh and hyperventilate?
…aggressive, angry, irritable, headachy, nauseated?
 …lethargic, dull, in denial?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Do you dream of...
…activity, running, flying, frightening things?
…violence, fire, anger, passion, the sun?
 …romance, sentimentality, water and snow?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 When making decisions, are you...
…unsure?
…quick and decisive?
 …deliberate?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Emotionally, do you...
…worry, become anxious, moody and emotional?
…get angry and irritated easily?
 …stay clam, complacent, get angry slowly?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes

 Do you love...
…traveling, art, esoteric subjects?
…sports, politics, luxury?
 …good food?
Never or almost never, no
Rarely, mild
Rarely, mild
 Rarely, mild
Sometimes, moderate
Sometimes, moderate
 Sometimes, moderate
Frequently, severe, yes
Frequently, severe, yes
 Frequently, severe, yes