The Kitchen Factory
NAME
AGE
CONTACT
E-MAIL
CATEGORY
LIFETIME
PRESENT – how do you feel now?
BODY FRAME
A : ThinB : moderateC : Thick
BODY WEIGHT
A : lightB : moderate weightC : Large, gains weight easily
SKIN TEXTURE
A : dry, rough or cracked; prominent veinsB : smooth, warm, rosy; freckles; slightly oilyC : pale; moist; soft; oily
HAIR QUALITY
A : coarse, dry; split endsB : fine, soft; can go gray or bald earlyC : abundant, oily, thick, lustrous
JOINTS
A : cold, crackingB : moderateC : Large, lubricated
APPETITE
A : Irregular, variableB : strong, unbearableC : Slow but steady
DIGESTION
A : variable or weak; often has allergies; forms gasB : Strong, able to digest almost anythingC : medium or slow but steady, Forms mucous
NAILS
A : dry, fissured, brittle, break easilyB : pink, LustrousC : thick, oily, smooth
ELIMINATION
A : Dry, hard, constipatedB : soft, oily, looseC : thick, oily, smooth
PHYSICAL ACTIVITY
A : HyperactiveB : ModerateC : Sedentary
SLEEP
A : Light, tends towards insomnia, restlessnessB : moderate, but soundC : Deep, prolonged –not a morning person
MOST COMMON FOOD CRAVINGS
A : dry, sweet, salty – crispy snack foodsB : spicy, salty, hotC : Sweet, creamy, cold
EATING HABITS
A : binges, snacks, forgets to eatB : likes regular, plentiful meals on timeC : eats constantly, overeats regularly
FOOD SENSITIVITIES (more than one indicates food allergies & Imbalance)
A : Beans, cabbage familyB : onions, tomatoes, fried foodsC : Dairy, salt
SWEAT & BODY ODOUR
A : little sweat, no odorB : profuse sweating, strong odorC : moderate sweating, moderate odor
DISORDERS
A : pain, insomnia, mental disorders, eating disorders, ArthritisB : Fevers, ulcers, infections, inflammatory diseases, heart attacksC : respiratory system diseases, mucus accumulation,
SPEECH HABITS
A : quick, talkativeB : argumentative, convincingC : not talkative, concise, slow
MENTAL NATURE
A: quick, adaptable, indecisive, impulsiveB : factual, penetrating, criticalC : slow, steady
EMOTIONAL RESPONSE to CONFLICT
A : quick, but soon overB : hot, irritated or defensive; holds grudgesC : slow, but lingers for a long time
SPENDING HABITS
A : spends easilyB : spends for a purposeC : spends with difficulty