AGU Clinic for Integrated Care, Holistic Health & Wellness


Check boxes that relate to your body type
Thin body size
Medium body size
Large body size
Low body weight and hard to gain weight
Moderate body weight
Over weight or gain easily
Skin type dry
Skin type smooth
Skin type oily
Hair dry
Some loss of hair
Thick and oily hair
Nails dry or easily broken
Nails grow fast and long
Nails smooth and shiny
Teeth big with thin gums
Teeth medium with soft gums
Teeth healthy, white with strong gums
Eyes small
Eyes sharp, medium and may be sensitive to strong light
Eyes big
Lips dry
Lips can get inflamed
Lips pale and smooth, large
Neck, Thorax, Belly, Hips size small or thin or flat
Neck, Thorax, Belly, Hips size medium
Neck, Thorax, Belly, and Hips big or large or compatible to larger frame of the body
Joints small and cracking sound
Joints medium and less cracking noise
Joints large and flexible
Less muscle mass
Medium muscle mass
Large muscle mass
Stress easily
Stess moderately
Stress rarely
Get pain easily
Get pain but tolerate
Get less pain
Digestion Irregular
Digestion good and never skip meals
Digestion slow
Thirst variable
Thirst moderate
Thirst sparse
Appetite irregular
Appetite normal and strong
Appetite regular or normal
Gas, Constipation
Heartburn, Acid
Mucous formation
Sleep irregular
Sleep moderate
Sleep long
Memory shortterm good but also forget
Memory accurate and good
Memory sustained but take longer
Physically active
moderately active
little physical activity
Energy level high
Energy level moderate
Energy level poor
Mental activity hyper
Mental activity moderate
Mentally calm and relaxed
Think quick not precise
Think precise and articulate
Think slow, paced
Brain state tired
Brain state conscious and critical
Brain state foggy and lack of clarity
Some emotional issues
No emotional issues
Some career and work stress
No career or work stress
Some financial stress
No financial stress
Environmentally sensitive to cold
Environmentally sensitive to heat
Environmentally sensitive to humidity
Do you smoke?
Do you drink alcohol?
Do you eat fast food?
Do you eat a lot of meat
Do you have high BP?
Do you have high cholesterol?
Immunity Good
Immunity poor
Metabolism good
Metabolism slow
Muscle tone and strength good
Muscle tone and strength getting poor
Vision 20/20
Vision poor
Postural balance good
Postural balance poor
Concentration and reflex good
Concentration and reflex poor
Aging faster
Aging normal
Any sadness?
Any mental health concern
some physical or mental fatigue
No physical or mental fatigue
Do you want individualized wellness program?