Energetic Assessment

Name

First NameLast Name
Email*
example@example.com
Assessment Type
Physical

	Slight	Medium	Large
Body Frame

	Difficult to gain	Average, easy to lose	Heavy, difficult to lose
Weight

	Dry, Crackly	Average, Mobile	Large, Lubricated
Joints

	Dry, Corse, Wirey	Fine, Soft, Wavy	Profuse, Thick, Straight
Hair

	Small, Sharp, Darting	Piercing, Deep, Almond	Large, Inviting
Eyes

	Dry, Cracked	Olive, Medium	Pale, Oily, Smooth
Skin

	Sharp, Pointy	Medium Size	Large, Flat
Nose

	Difficulty Sleeping, Waking around 2 am	Average sleeping, Easy to wake	Deep sleep, Difficult to wake
Sleep

	Cold Extremities	Warm	Cold Body
Body Tempature

Intellectual

	Anxious, worried	Anger, frustration	Logical
Response to Stress

	Shy, Quiet, Subdued	Active, Aggressive, Ambitious	Sedentary, Methodical, Judicial
Temperment

	Difficult	Moderately difficult	Natural
Ability to relax

	Moderate	Strong	Weak
Drive

	Variable	Average	Strong
Focus

	Quick to learn, Quick to forget	Sharp	Slow, Sustained
Intellect

Emotional

	Pessimistic	Optimistic	Judicial
Temperment

	Skeptical	Trusting	Analytical
Interpersonal

	Explosive	Aggressive	Passive Aggressive
Confrontation

	Low	High	Average
Self-esteem

	Lacking or Profuse	Direct	Passive
Communication Sytle

Spirituality

	Variable	Devote	Scientific
Connected to Higher Power

	Personal Ritual	Community Ritual	Avoids Ritual
Ritualistic

	Recharges in nature	Connects to nature	Avoids nature
Connected to Nature

	Excessive	Inflated	Moderate
Ego

Should be Empty: