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