Full Name *

Email *

Which best describes your body frame? *

Small, thin, light bones

Medium build, athletic

Large, broad, solid

None of the above

What best describes your skin? *

Dry, rough, thin

Warm, oily, prone to redness

Cool, oily, smooth

None of the above

Which best describes your hair? *

Dry, frizzy, or fine

Oily, fine, prone to thinning

Thick, oily, wavy

None of the above

How would you describe your appetite? *

I have irregular hunger. Sometimes I'm hungry, sometimes I forget to eat. Schedules in general are challenging for me.

I often experience strong hunger. I get hangry and may get nauseous if I go too long without food.

I don't often feel hungry, although I will eat emotionally. My meals often feel like they sit in my stomach.

None of the above

How would you describes your digestion? *

Irregular appetite and digestion (gassy, burping, dry hard stool, constipated)

Strong appetite, feel hungry often (prone to sour stomach/belching, nausea, acidity, reflux, soft/loose stool)

Slow digestion, heavy feeling after eating (cold, congestion, lethargy after food, slow/sticky stool)

None of the above

Which best describes how you move through the world? *

Creative, quick, restless

Driven, competitive, intense

Calm, stable, nurturing

None of the above

What best describes your energy levels? *

Depends on the day, comes in bursts

High, intense, focused

Steady, consistent, low stamina

None of the above

Which best describes your response to stress? *

Anxious, worry easily, run away

Irritable, frustrated, fight

Withdrawn, sluggish, stuck

None of the above

What foods do you typically crave most? *

I crave salty crunchy snacks: chips, crackers, trail mix, popcorn.

I crave spice: onions, garlic, chilis and like beverages with some sharpness like coffee and wine.

I crave the sweet taste: sugars, carbohydrates, meat, dairy, sweet drinks and fruits.

None of the above

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