Allocca Biotechnology, LLC - Ayurvedic Dosha Assessment


Personal Data

Name
Street Address
City
State
Zip Code
Area Code and Phone Number
Email Address


Dosha Questions

Check ONLY ONE Answer from each Category

Physique
I am a slender person and I hardly gain weight
I am medium build
I am well built and I gain weight no matter what I do

Skin
My skin is dry, thin, and itches often
My skin looks flushed; I have lots of moles and freckles on my body
My skin is smooth and soft, it looks pale sometimes

Hair
My hair is dry, thin and brittle
My hair is neither dry nor oily (men, receding hairline)
My hair is thick, full, lustrous, and slightly oily

Face
My face is oval
My face is triangular (pointed chin, prominent jaw line)
My face is round

Eyes
My eyes are small; they feel dry often and have a bit of dullness (usually brown)
My eyes are medium in shape; sharp & penetrating (usually blue or amber)
My eyes are big and round in shape, full eyelashes

Hands
My hands are generally dry, rough; slender fingers; dry nails
My hands are generally moist, pink; medium fingers; soft nails
My hands are generally firm, thick; thick fingers; strong & smooth nails

Joints
My joints are small, prominent bones, and often crack
My joints are medium and loose
My joints are large, sturdy, with lots of muscle surrounding

Activities
I am a very active person (always on the go, mind constantly thinking)
I like to think before I do anything
I am steady and graceful (I don't like to rush)

Actions
I walk fast and talk fast
My actions are very thoughtful and precise
I like a slower pace and I take my time to accomplish things

Sleep
I do not sleep soundly at night. I tend to toss and turn. I wake up early in the morning
I am a light sleeper but if something wakes me up, I can go back to sleep easily
I am a heavy sleeper

Appetite
Varies, sometimes I feel hungry, sometimes not, I feel anxious if I don't eat
I always feel hungry. If I don't eat I get irritable and angry
I don't feel very hungry. I can go without food easily for a day

Bowel Movements
I tend to have constipation and can go a day or two without a bowel movement
I am regular and sometimes stools are loose (tend to get diarrhea)
I have no problem. I wake up to go to the bathroom.

Voice
My voice tends to be weak or hoarse
I have a strong voice, I may get loud sometimes
My voice is deep, has good tone

Emotions
I am a born worrier, I often feel anxious and nervous
If things don't happen my way, I feel irritable and angry
I am a happy person, very caring and loving

Weather Preference
I love warm and humid weather
I enjoy cool weather, I dislike a warm climate
I like warm but dry weather

Perspiration
I perspire little but not much
I perspire profusely and it might have an unpleasant odor
I never perspire, unless working very hard

Memory
I remember quickly and forget quickly
I remember what I want to remember and never forget
It takes me a while to remember, but once I do I never forget

Action Plans
I tend to be spontaneous
I am a list maker. Unless I plan,I don't do anything
I don't like to plan, I prefer to follow others

Stamina
I like to do things in spurts and I get tired very easily
I have medium stamina
I can work long hours and maintain good stamina

Mind
My mind gets restless easily (it starts racing
I get impatient easily
It takes a lot to make me mad. I usually feel very calm

Decision Making
I change my mind more often and will take time to make a decision
I can make a decision easily and stick with it
I want others to make the decisions

Personality
Can I change my mind?
It is my way or no way
Don't worry be happy

Sports
I like action
I like to win
I like to have fun

Health Problems
My symptoms are mainly pain, constipation, anxiety and depression
I often get skin infections, fevers, heart burn, hypertension
I tend to get allergies, congestion, weight gain and digestive problems

Hobbies
I like art (drawing, painting, dance) and travel
I like sports, politics, and things that get my adrenaline pumping
I like nature, gardening, reading, and knitting