RIVERWALK – NATURAL – HEALTH – CLINIC
Deborah A. Wiancek, N.D.
This
questionnaire is provided to help you determine your Ayurvedic
constitution. Select one answer for each
question. If more than one answer is
applicable, choose the one that applies the most. Some answers will be obvious (such as hair
color, height, dry skin, etc.). Others
will be more subjective and variable. If
in doubt, answer according to how you have been for most of your life,
especially for the past few years. At
the end of the questionnaire, add the number of A’s, B’s, and C’s to determine your
body-mind constitution.
Body
Frame
A.£ Taller or shorter
than average, thin and slender, with prominent joints and thin muscles. B.£ Medium build, with
good muscle development. C.£ Large, round,
solid body frame, with a heavy bone structure.
Weight
A.£ Low; difficulty
gaining weight. B.£ Moderate; it’s
easy to gain weight or lose weight if I put my mind to it. C.£ Heavy; I gain
weight easily and have difficulty losing it.
Hair
– two or more of the following options:
A.£ Dry, coarse,
kinky, curly, brown, black. B.£ Fine, soft, red,
light brown, blonde, prematurely graying or balding. C.£ Abundant, thick,
oily, wavy, brown, black.
Eyes
A.£ Small, dry, brown,
active. B.£ Sharp,
penetrating, green, blue, gray, with reddish or yellowish sclera. C.£ Large, attractive,
brown or deep blue, with white sclera.
Teeth
A.£ Crooked, uneven or
with large spaces, sensitive to hot or cold, need for braces. B.£ Medium-sized,
yellowish, gums bleed easily. C.£ Large, straight,
white.
Skin
A.£ Dry, rough, thin,
darker (relative to family), tans easily. B.£ Fair skin,
sunburns easily, warm, reddish in color, prone to irritation. C.£ Moist, thick,
smooth.
Temperature
A.£ Cold hands and
feet, dislikes cold weather, prefers warm environments. B.£ Usually warm
regardless of season, sweats easily, prefers cooler environments. C.£ Cool (not cold)
and clammy, adaptable to most temperatures but dislikes cool, wet weather.
Appetite
A.£ Unpredictable and
variable; sometimes not hungry at mealtimes and hungry between meals. B.£ Strong; acutely
aware of mealtimes, irritable when delaying or missing a meal, can digest large
quantities of food. C.£ Moderate; can
comfortably miss a meal, feels best with smaller quantities of food.
Bowel
Movements
A.£ Irregular, tends
toward constipation, hard and dry stool, accompanied by gas. B.£ Regular, two or
more bowel movements per day, loose/soft stools, occasional burning. C.£ Regular pattern,
usually one large, full bowel movement per day.
Sleep
A.£ Light or
interrupted, insomnia, 5-7 hours per night. B.£ Sound, 6-8 hours
per night. C.£ Deep,
uninterrupted, love to sleep, slow to waken
Dreams
A.£ Flying, running,
fear, searching, traveling. B.£ Fire, conflict,
anger, vivid colors, passion, jealousy. C.£ Water, romance,
sadness, ocean, clouds, short dreams.
Work Habits
A.£ Selfless, often
volunteers to help out. B.£ Works intensely,
especially to achieve personal goals. C.£ Procrastinates,
sometimes lazy, takes time to complete projects.
Activity
Pattern
A.£ Performs
activities very quickly, energy levels fluctuate and come in bursts, often
multi-tasks, easily distracted and may not complete projects. B.£ Performs
activities intensely and efficiently, perfectionist mindset, likely to become
aggravated if interrupted or encounter difficulties. C.£ Performs
activities slowly, calmly, and deliberately, steady energy level with good
endurance and stamina.
Learning
Pattern
A.£ Very quick
learner, but forgets things easily. B.£ Moderately quick
learner, clear on details, average memory.
C.£ Slow learner, but
never forgets information once it is learned.
Disease
Pattern
A.£ Joint aches, low
back pain, indigestion, intestinal gas, constipation, insomnia, anxiety,
fatigue, weakness, dryness. B.£ Skin conditions
(rashes, acne), ulcers, inflammations, fevers. C.£ Respiratory
conditions, cough with mucus, sinus/nose/throat congestion, benign growths,
obesity, diabetes, fluid retention.
Temperament
A.£ Lively, easily
excitable, changeable moods, enthusiastic.
B.£ Perfectionist,
driven, intense, opinionated. C.£ Easy-going, calm,
satisfied, accepting.
Reaction
to Stress
A.£ Fearful, anxious
and/or worried. B.£ Anger,
irritability, and/or aggressive. C.£ Withdrawn and/or
reclusive.
Sensitive
to:
A.£ Noise. B.£ Bright lights. C.£ Strong odors.
My
family and friends might prefer me to be:
A.£ Settled. B.£ Tolerant. C.£ Enthusiastic.
This
questionnaire made me feel:
A.£ Indecisive. B.£ Annoyed. C.£ Sleepy.
Final
Score: A._____
B._____ C._____
œ œ œ
Vata
Pitta Kapha
The
letter A corresponds to Vata.
B corresponds to Pitta.
C corresponds to Kapha.
Your predominant dosha(s) determine your Ayurvedic constitution. Some individuals have one predominant dosha
(either vata, pitta, or kapha). Some
individuals have two equally predominant doshas (for example, pitta-vata or
kapha-pitta). Rarely, a few individuals
will have equal proportions of all three doshas. While not an exact tool, this questionnaire
should give you a good idea of your unique Ayurvedic constitution. A better and more exact determination of your
constitution requires the insight and skill-set (including face, tongue, and
pulse diagnosis) of a trained Ayurvedic practitioner.
