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| VATA | Not True at All | Very True | |||
| I don’t like cold weather | 0 | 1 | 2 | 3 | 4 |
| I don’t gain weight easily | 0 | 1 | 2 | 3 | 4 |
| I often become anxious and restless | 0 | 1 | 2 | 3 | 4 |
| My moods change quickly | 0 | 1 | 2 | 3 | 4 |
| I am creative, imaginative | 0 | 1 | 2 | 3 | 4 |
| I walk quickly | 0 | 1 | 2 | 3 | 4 |
| I have difficulty falling or staying asleep | 0 | 1 | 2 | 3 | 4 |
| I tend to make and change friends | 0 | 1 | 2 | 3 | 4 |
| I learn quickly and forget quickly | 0 | 1 | 2 | 3 | 4 |
| I become constipated easily | 0 | 1 | 2 | 3 | 4 |
| Under stress I am easily excited | 0 | 1 | 2 | 3 | 4 |
| I have an irregular appetite | 0 | 1 | 2 | 3 | 4 |
| My skin tends to be dry, rough, especially in winter | 0 | 1 | 2 | 3 | 4 |
| My feet and hands tend to be cold | 0 | 1 | 2 | 3 | 4 |
| My hair tends to be dry | 0 | 1 | 2 | 3 | 4 |
| VATA TOTAL __________ |
| PITTA | Not True at All | Very True | |||
| I don’t like hot weather | 0 | 1 | 2 | 3 | 4 |
| My weight is average for my build | 0 | 1 | 2 | 3 | 4 |
| I tend to become intense, irritable | 0 | 1 | 2 | 3 | 4 |
| My moods are intense and change slowly | 0 | 1 | 2 | 3 | 4 |
| I am intelligent, efficient, a perfectionist | 0 | 1 | 2 | 3 | 4 |
| I have a determined walk | 0 | 1 | 2 | 3 | 4 |
| I sleep well, for an average length of time | 0 | 1 | 2 | 3 | 4 |
| Most of my friends are work-related | 0 | 1 | 2 | 3 | 4 |
| I have a good general memory | 0 | 1 | 2 | 3 | 4 |
| I have regular bowel habits | 0 | 1 | 2 | 3 | 4 |
| Under stress, I am easily angered, critical | 0 | 1 | 2 | 3 | 4 |
| I am uncomfortable skipping meals | 0 | 1 | 2 | 3 | 4 |
| My skin is soft, ruddy | 0 | 1 | 2 | 3 | 4 |
| I like cold foods and drinks | 0 | 1 | 2 | 3 | 4 |
| My hair is fine, thin, reddish, or prematurely gray | 0 | 1 | 2 | 3 | 4 |
| PITTA TOTAL __________ |
| KAPHA | Not True at All | Very True | |||
| I don’t like damp, cool weather | 0 | 1 | 2 | 3 | 4 |
| I gain weight easily | 0 | 1 | 2 | 3 |
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