Body Constitution

Name *

First Name

Last Name

Frame

thin, boney (vata)

moderate, good muscle (pitta)

large, well-developed (kapha)

Weight

low, difficult to gain (vata)

moderate (pitta)

heavy, hard to lose (kapha)

Skin

dark, cold, rough, dry, thin (vata)

rosey, warm, oily (pitta)

pale, cool, oily, thick (kapha)

Eyes

small, dry, often brown (vata)

penetrating, lighter colors (pitta)

big, beautiful, loving, calm (kapha)

Hair

dry, thin, curly (vata)

blond/gray/red, bald, soft (pitta)

thick, oily, wavy, lustrous (kapha)

Nose

uneven shape (vata)

long, pointed, red tip (pitta)

soft, rounded, button (kapha)

Teeth

protrude, big roomy, thin gums (vata)

medium, yellow tint, soft gums (pitta)

healthy white, strong gums (kapha)

Check/Hips/Belly

thin, flat, sunken (vata)

moderate (pitta)

expanded, round (kapha)

Nails

hard, brittle, split easily (vata)

soft, pink, lustrous (pitta)

thick, whitish, smooth (kapha)

Voice

rapid, unclear, quick, talkative (vata)

sharp, moderate, clear, precise (pitta)

slow, labored, or deep tonal (kapha)

Thirst

changeable (vata)

very thirsty (pitta)

sparsely thirsty (kapha)

Walk

quick, light, hurried (vata)

med. paced, purposeful (pitta)

slow, steady, calm (kapha)

Disease Tendency

nervous, pains, gas, eczema (vata)

inflammation, rashes, heartburn (pitta)

fluid retention, bronchitis, sinus (kapha)

Sweat

minimal (vata)

profuse, esp. when hot (pitta)

moderate, cool, clammy (kapha)

Temperature Pref.

craves warmth (vata)

loves coolness (pitta)

prefers heat (kapha)

Elimination

Option 1

Option 2

Appetite

variable, small (vata)

strong, regular (pitta)

slow, steady (kapha)

Digestion

irregular, forms gas (vata)

strong, quick, tends towards burning (pitta)

slow, forms mucous (kapha)