docchakra consultation questionnaire ver 3
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chakra consultation questionnaire ver 3
Client Chakra Consultation Questionnaire ORGANICS Part 2. Instructions: For each question on the left to which you answered: (YES), shade in the corresponding number field in the circles below. Part 1. Instructions: Respond to these statements with an absolute YES, NO, or SOMETIMES. Don’t think about them too much. Your answers should be intuitive and spontaneous. (NO) circle the corresponding number field in the circles below. Part 3. (SOMETIMES). Leave these blank Test Evaluation 1. I generally feel in harmony with the universe............................ NO SOMETIMES YES 2. My intuition is extremely developed.......................................... NO SOMETIMES YES 3. I express myself well in words.................................................. NO SOMETIMES YES 4. I feel emotionally connected with other people......................... NO SOMETIMES YES 5. I follow my gut instincts............................................................ NO SOMETIMES YES 6. I am full of vitality and life......................................................... NO SOMETIMES YES 7. I love to be in movement and feel my own body........................ NO SOMETIMES YES 8. It is easy for me to meditate and find inner peace..................... NO SOMETIMES YES 9. I have good concentration......................................................... NO SOMETIMES YES 10. I feel socially confident........................................................... NO SOMETIMES YES 11. I do not fear being alone......................................................... NO SOMETIMES YES 12. Eating is one of the great pleasures in life.............................. NO SOMETIMES YES 13. I know how to enjoy life.......................................................... NO SOMETIMES YES 14. I almost never worry............................................................... NO SOMETIMES YES 15. I find it difficult to take the world seriously.............................. NO SOMETIMES YES 16. I often think about the world and life....................................... NO SOMETIMES YES 17. I can easily put my thoughts into words.................................. NO SOMETIMES YES 18. Love is the most important thing in the world.......................... NO SOMETIMES YES 19. I am at peace with myself and not easily thrown off center..... NO SOMETIMES YES 20. I am a very passionate person................................................. NO SOMETIMES YES 21. I feel deeply connected with nature......................................... NO SOMETIMES YES 22. My soul's home does not lie in this world................................ NO SOMETIMES YES 23. I have intense color-filled dreams............................................ NO SOMETIMES YES 24. I have many different interests............................................... NO SOMETIMES YES 25. I have the desire to express myself artistically......................... NO SOMETIMES YES 26. I experience feelings mostly in my body................................... NO SOMETIMES YES 27. Sex is very important to me..................................................... NO SOMETIMES YES 28. I have a lot of confidence in life and the future........................ NO SOMETIMES YES Crown Chakra 1 8 Dominating Chakra 15 Weak Chakra 22 Blocked Chakra Third Eye Chakra 2 9 Weak Chakra 23 Blocked Chakra Throat Chakra 3 Weak Chakra 24 Blocked Chakra Heart Chakra 4 Weak Chakra 25 Blocked Chakra Solar Plexus Chakra 5 Weak Chakra 26 Blocked Chakra Sacral Chakra 6 Weak Chakra 27 Blocked Chakra Root Chakra 7 21 28 Balanced & Unblocked Dominating Chakra 20 14 Balanced & Unblocked Dominating Chakra 19 13 Balanced & Unblocked Dominating Chakra 18 12 Balanced & Unblocked Dominating Chakra 17 11 Balanced & Unblocked Dominating Chakra 16 10 Balanced & Unblocked Balanced & Unblocked Dominating Chakra Weak Chakra Blocked Chakra greenenvee.com ORGANICS Chakra Test Result Key Chakra Equally Developed and Unblocked Dominant Chakra Weak Chakra Extremely Weak Chakra Blocked or Closed Chakra (1 or more circled numbers) Extremely Blocked or Closed Chakra (2 or more circled numbers) Individual Chakra Result Balanced and Healthy (No need for current improvement) Over Developed (Do not intentionally nourish at this time) Under Developed (Needs nourishment) Under Developed (Needs immediate nourishment) Under Developed (Needs nourishment) Under Developed (Needs immediate nourishment)
