To help us understand your needs, please complete the following questionnaire, so we can do an analysis of your dosha (impurities). Take your time in completing this questionnaire and answer truthfully; it will only benefit you and your home. If you are looking to implement Vaastu in your entire home, only the leading members of the home (ie. Husband and Wife) should complete the questionnaire; one questionnaire per leading member. If you are only looking to implement Vaastu in one room of your home or office, only the person(s) using that room should complete one questionnaire per person.

Name: Address: Phone No.: Alternative Ph No.: How did you hear about us? Why are you looking to bring Vaastu into your life? 1. What are your sleeping patterns? a) Are you a light sleeper and wake up easily in the night? b) Do you sleep well and rarely have sleepless nights? c) Do you enjoy a deep and heavy sleep? 2. How many hours of sleep do you need in order to feel well rested? a) Four to six hours? b) Six to eight hours? c) Over eight hours? 3. How physically active are you? a) Is your exercise regimen limited? b) Do you exercise moderately? c) Is exercise part of your daily lifestyle? 4. What would you characterize your body type as? a) Do you think of yourself as underweight, thin and slim? b) Are you at a healthy weight for your age and height? c) Do you consider yourself to be slightly overweight and could stand to lose a couple of pounds? 5. How easily do you put on weight? a) Do you have a hard time putting on weight? b) Is your weight gain appropriate to your activities and diet? c) Is it very easy for you to gain weight? 6. What are your eating habits? a) Do you eat whenever you are hungry and eat as much as you feel is necessary at that time to fill your hunger? b) Do you have a scheduled meal regimen and feel hungry if you go off schedule? c) Are you always eating but in small portions? 7. What is your level of thirst like? a) Does it vary from day to day and has no consistency? b) Are you generally always thirsty? c) Are you hardly ever thirsty and rarely drink? 8. Which of the three options are you more likely to complain about to your doctor? a) Joint aches or stiffness b) Gastrointestinal or stomach problems c) Respiratory or breathing problems 9. What is the condition of your skin? a) Does your skin get very dry and itchy easily? b) Do you tend to get freckles, moles or rashes easily? c) Is your skin well moisturized and soft; never really have problems with it? 10. Which digestive problem, if any, do you suffer from the most? a) Gas or constipation? b) Diarrhea? c) Problems with bowel movements? 11. How would you measure your level of perspiration? a) Do you perspire or sweat very little? b) Do you perspire a lot? c) Do you perspire moderately? 12. What is your gait or sense of urgency? a) Do you move quickly? b) Do you move at a moderate pace? c) Are you happy when you are way ahead of schedule and your feet don’t have to move at all? 13. What types of weather conditions bother you the most? a) Windy and Cold b) Extremely Hot c) Damp and Cold 14. You have been waiting for your spouse or friend for over an hour to pick you up from work. a) Do you become anxious? b) Do you get angry? c) Do you forgive them when they arrive? 15. What is your temper like? a) Do you get angry quickly and calm down just as quickly? b) Do you become furious and sometimes express yourself verbally with piercing words? c) Do you find a way to somehow control your anger? 16. How decisive are you? a) Are you easily swayed to change your mind if you make a decision? b) Do you stand by your decision and quickly put it into action? c) Does it usually take you a while to make up your mind? 17. How superstitious are you? a) Are you cautious and consult with your horoscope on a daily basis? b) Do you believe in some things, but not all superstitions? c) Do you ignore them all and do whatever feels right? 18. What statement best defines how good your memory is? a) Don’t even bother telling me because I’m going to forget anyways! b) Pretty good! I did well on school tests. c) Awesome! I have a photographic memory! 19. What word would you describe yourself as being in a social setting? a) Full of life b) Intense c) Relaxed 20. If you had to pick a second word, what would it be? a) Adaptable b) Ambitious/Determined c) Easygoing/Laid Back 21. What are your communication skills like? a) Do you love talking and have a hard time keeping quiet? b) Are you an intense speaker and only say what you feel and think? c) Do you choose your words very wisely and only speak when necessary? 22. How is your general disposition or nature? a) Are you very unpredictable and your mood changes like the seasons? b) Are you always intense and feel like you are always under pressure? c) Are you calm and steady and are very predictable? 23. What is your level of energy throughout your day like? a) Does your energy come to you in bursts? b) Do you manage to maintain your energy level throughout your day? c) Is your energy level slow and steady? 24. How do you walk? a) Are you a fast walker? b) Do you have a determined and confident stride? c) Do you enjoy a slow and measured pace throughout your day? 25. What are your project management skills like? a) Do you get right into a project and then lose interest along the way? b) Do you hate wasting time and are quick to reach your goals? c) Do you take it easy with your projects and feel that if you can’t finish it today, there is always tomorrow? 26. What type of person are you in a group project? a) Are you an independent worker and likes to take ownership of their hard work? b) Do you like to take charge of the group and are a born leader? c) Do you enjoy just being part of the team knowing that your efforts are making a difference in the big picture?

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