Name *

First Name

Last Name

Phone *

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Body type?

Thin and unusually tall or short

Medium body and height

Large build

Bone structure?

Light/small bones and/or prominent joints

Medium bone structure

Heavy large stocky bone structure

Hands and Feet?

Long tapering fingers/toes

Medium fingers/toes

Large, stocky fingers/toes

Childhood weight?

Thin as a child

Medium as a child

Weight heavier throughout childhood and on

Weight gain?

If weight gain, it's around the middle; difficulty gaining weight

If weight gain, it's evenly distributed; gain/lose weight if focused

Weight gains mainly in rear/thighs; gains weight easily, hard losing it

Complexion?

Dark complexion, tans easily, dry

Fair skin, burns easily, freckles, ruddy

Tans evenly, glowing

Body hair?

Body hair is scanty or overly abundant - tends to be coarse, curly

Light body hair, finely textured

Moderate amount of body hair

Forehead?

Small forehead with lines

Medium forehead with folds and lines

Large forehead usually few lines

Eyes?

Small active eyes, darker color

Medium light-green, grey, amber or blue, intense gaze

Large, liquid eyes, easy to look at

Teeth?

Crooked, uneven, buck teeth; braces when younger

Medium, even teeth, gums bleed easily

Large, even, gleaming teeth

Chin?

Delicate chin

Moderate chin

Large chin and jaw

Hair?

As a child, hair kinky/curly

As a child, hair fine/light, blond

As a child, hair wavy/thick

Pulse?

Thin, fast, variable pulse; cold hands

Strong, full pulse; warm hands

Steady, slow, rhythmic pulse; medium temp hands

Nails?

Brittle nails

Flexible nails but strong

Strong thick nails not flexible

Thirst?

Changeable

Excessive

Sparse

Memory?

Good short-term memory but forgets easily

Quick memory, accurate past and future

Slow memory recall but accurate past and future

Routine?

Dislikes routine

Enjoys planning/organizing, especially if self-created

Works well with routine

Decisions?

Decisions difficult, changes mind easily

Quick decisions

Slow to make decisions but unchangeable after made

Activity?

Likes to stay physically active

Exercises to reduce stress, enjoys competitive sports

Likes leisurely activities, games, cards, movies

Personality?

Creative, spontaneous, artist

Organized thinker/leader, likes order

Prefers to work under routine and to support ideals and goals of work environment or organization

Multitasking?

Does many projects all at once, prefers multitasking, often tasks undone

Prefers organization and order in projects, projects few but tasks completed

Prefers simplicity, straight forward work, dislikes change and complications in work, slow and steady

Social circle?

Knows a lot of people, few close friends

Very selective with friends, makes enemies easily

Very loyal and has many friends

Spending?

Spends money impulsively

Plans spending money on special purchases

Spends money reluctantly, likes to save

Perspiration?

Cold hands/feet, perspires little

Usually warmer than others, perspires easily

Moderate circulation and perspiration

Sleep?

Light sleeper, wakes frequently

Usually sleeps well

Sound, heavy sleeper (8+ hours)

Climate?

Prefers warm climate, sunshine, moisture. Dislikes dry, cold

Prefers cool, well-ventilated places

Tolerates most climates as long as not too humid

Skin?

Prone to dry skin and calluses

Oily skin, prone to pimples and rashes

Thicker skin, moist, no need for lubrication

Lips?

Small, thin, easily chapped

Medium, tendency toward blisters, cold sores

Full, moist lips

Bowel movements?

Irregular, hard, dry; constipation

Tendency toward loose stools (2x day)

Large full bowel movements (1x daily), takes longer to have

Menstruation?

(If applicable)

Menses irregular, scanty flow, severe, painful cramps

Heavy flow, but of shorter duration often loose stools accompany menses

Prone to water-weight retention during menses, slight cramps moderate flow

Gums?

Prone to receding gums

Prone to inflamed, bleeding gums

Thick healthy gums

Joints?

Prone to Joints cracking stiffness

Prone to Joints becoming inflamed

Prone to loose, joints that swell and have congestion

Appetite?

Variable appetite, likes to skip meal

Appetite very good, irritable if meal is missed

Consistent appetite, little slow can skip meals without physical problems

Snacking?

Likes to snack and nibble crunchy dry foods preferred

Likes spicy flavor, proteins and caffeine

Likes sweets, dairy, breads, pastry

Stress response?

Under stress tends toward fear, anxiety, self destructive behavior

Under stress tends towards irritability, anger, frustration; tends to point fingers at others; can be more focused under stress

Under stress tends towards avoidance behaviors which creates apathy

Speech?

Speech rapid and unclear

Speech, sharp and penetrating

Speech slow, monotonous

Intellect?

Quick, fast paced mind but faulty response

Strong, accurate response

Intellect slow, but exact response

Worst quality?

Victim mentality, self destructive behaviors, sneaky

Blaming others and not taking responsibility, manipulative

Avoidance of difficult situations, not being direct, apathy, laziness, hoarding

Best quality?

Flexibility and creativity

Directness and leadership

Steadiness, loyalty, acceptance and compassion

Dreams?

Flying, restless dreams, prone to nightmares

Action-packed dreams with conflicts and passion

Romantic, shorts dreams, often with water