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Question 1 of 20
1. Question
What time do you wake up at? Describe your morning routine.
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 2 of 20
2. Question
What time do you go to sleep at? Describe your evening routine.
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 3 of 20
3. Question
What time do you eat breakfast, lunch and dinner at? What do you typically eat at each of these meals.
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 4 of 20
4. Question
How do you sleep?
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Poor Perfect
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Question 5 of 20
5. Question
How is your digestion?
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Poor Perfect
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Question 6 of 20
6. Question
How is your elimination?
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Poor Perfect
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Question 7 of 20
7. Question
Rate your stress level
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Poor Perfect (no stress)
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Question 8 of 20
8. Question
Rate your happiness level
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Poor Perfect
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Question 9 of 20
9. Question
Rate your health level
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Poor Perfect
CorrectIncorrect -
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Question 10 of 20
10. Question
Are you currently satisfied in your job?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 11 of 20
11. Question
Are you currently satisfied in your core relationships?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 12 of 20
12. Question
Describe your communication with your significant other
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 13 of 20
13. Question
Are your satisfied with your body?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 14 of 20
14. Question
Do you meditate? If so, how often?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 15 of 20
15. Question
Do you have a yoga practice? If so, how often do you practice.
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 16 of 20
16. Question
Do you exercise? If so, what type and how often?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 17 of 20
17. Question
Do you drink caffeine? If so, how often?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 18 of 20
18. Question
Do you use tobacco? If so, how often?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 19 of 20
19. Question
Please list any medications.
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -
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Question 20 of 20
20. Question
Do you have any additional comments?
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This response will be awarded full points automatically, but it will be reviewed and possibly adjusted after submission.
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted. -