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Dosha Self-Assessment Questionnaire

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What is My Mind/Body Type?

Ayurveda offers a framework for understanding individual differences and how to harmonize with them to maintain balance in the face of change in order to enjoy a long, vital life. These differences are captured by the Sanskrit word Prakriti, which means manifest Nature. Individual Prakriti is most simply described as a proportion of the three Doshas Vata, Pitta and Kapha, which respectively reflect movement, metabolism and structure in mind and body.

Instructions for Completing the Dosha Self-Assessment Questionnaire
  • Respond to every item.
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Prakriti Assessment Questionnaire

When selecting your responses, think about what has been most generally true about you over the long term.

Body-Related Items
Please indicate the degree to which the following statements apply to you Strongly Disagree Disagree Somewhat Disagree Neutral Somewhat Agree Agree Strongly Agree
My joints make cracking sounds when I move 1 2 3 4 5 6 7
I am very strong by nature 1 2 3 4 5 6 7
I am experiencing hair loss (e.g., balding, receding hairline or thinning) 1 2 3 4 5 6 7
Especially in winter, my skin tends to get dry, rough or cracked 1 2 3 4 5 6 7
My skin is soft and oily 1 2 3 4 5 6 7
I sunburn easily 1 2 3 4 5 6 7
I have poor endurance 1 2 3 4 5 6 7
My hair is turning gray too early in life 1 2 3 4 5 6 7
I have many spots (like moles or freckles) on my skin 1 2 3 4 5 6 7
I get chilled easily, particularly in my hands or feet 1 2 3 4 5 6 7
I sweat a lot 1 2 3 4 5 6 7
Once I get started with physical activity, I can continue for a long time 1 2 3 4 5 6 7
My weight is below average 1 2 3 4 5 6 7
I gain weight easily 1 2 3 4 5 6 7
Mind-Related Items
Please indicate the degree to which the following statements apply to you Strongly Disagree Disagree Somewhat Disagree Neutral Somewhat Agree Agree Strongly Agree
Others find me sweet, friendly, gentle, kind and affectionate 1 2 3 4 5 6 7
I'm patient with others 1 2 3 4 5 6 7
I am quick to learn, but often quick to forget 1 2 3 4 5 6 7
It takes me some time to fall asleep 1 2 3 4 5 6 7
My sleep is heavy and sound 1 2 3 4 5 6 7
My speech is slow and sweet 1 2 3 4 5 6 7
I often have trouble making decisions 1 2 3 4 5 6 7
Regardless of what happens, I'm generally calm 1 2 3 4 5 6 7
I can be argumentative 1 2 3 4 5 6 7
I tend to be moody 1 2 3 4 5 6 7
I am scatterbrained 1 2 3 4 5 6 7
I am a perfectionist 1 2 3 4 5 6 7
When stressed, I'm prone to get excited or worry 1 2 3 4 5 6 7
If something upsets me, I'm quick to anger 1 2 3 4 5 6 7
I'm well-organized 1 2 3 4 5 6 7
I can be abrupt or sharp with others 1 2 3 4 5 6 7
I'm often impatient 1 2 3 4 5 6 7
I tend to be lazy and prone to procrastination 1 2 3 4 5 6 7
I am slow to learn, but don't often forget 1 2 3 4 5 6 7
Digestion-Related Items
Please indicate the degree to which the following statements apply to you Strongly Disagree Disagree Somewhat Disagree Neutral Somewhat Agree Agree Strongly Agree
My bowel habit is irregular. I am prone to constipation. 1 2 3 4 5 6 7
If I'm not thinking about it, I can easily skip a meal. 1 2 3 4 5 6 7
My bowel movements tend to be dry or hard 1 2 3 4 5 6 7
My bowel movements are regular, generally once or twice a day 1 2 3 4 5 6 7
I'm often thirsty 1 2 3 4 5 6 7
My hunger is strong. I can't comfortably skip meals. 1 2 3 4 5 6 7
Required Supportive Information

Your Gender Identity

Units of Measurement for both Weight and Height

Your Contact Information
Comments

Do your responses reflect your situation and represent permission to use your de-identified data in aggregate scientific studies? Clients should be able to comfortably answer yes. If not, please call to discuss.

For clients and prospective clients only: Do you wish to send a copy of your report to Elianne van Waalwijk van Doorn?