your sacral chakra has the greatest number of points. In this case, you could flip to the chapter on the sacral chakra (chapter 5) to read more about nourishing this chakra with foods.
Some of the questions relate to your physical body and may be more obvious than the questions on your emotions and thoughts. For the more subjective questions, try to answer how you have felt and acted for at least the past six months.
Section 1: Root Chakra
1 = Does Not Apply 3 = Applies Sometimes 5 = Applies All the Time
1 Most times I do not feel safe or I feel that my boundaries are violated. 1 2 3 4 5
2 I suffer from lack of energy and constant fatigue. 1 2 3 4 5
3 It is difficult to survive in this world. 1 2 3 4 5
4 Sometimes I feel like life isn't worth the effort. 1 2 3 4 5
5 I have a hard time sticking up for myself. 1 2 3 4 5
6 I lack initiative and may appear “lazy” to others. 1 2 3 4 5
7 For whatever reason(s), I am unable to be a part of a community and feel good about it. 1 2 3 4 5
8 My childhood left me feeling unloved. 1 2 3 4 5
9 Sometimes I resist and even despise family traditions and refuse to take part in them. 1 2 3 4 5
10 I am either physically or emotionally disconnected from my family of origin. 1 2 3 4 5
11 I frequently catch myself being spaced out or daydreaming, like I am not in my body. 1 2 3 4 5
12 Whenever a cold or flu is in the air, I am one of the first people to get it. 1 2 3 4 5
13 (For men) Impotence is a concern for me. 1 2 3 4 5
14 I feel unprotected, like I have to “watch my back.” 1 2 3 4 5
15 I struggle with my body image. 1 2 3 4 5
Root Chakra Total: ________
Section 2: Sacral Chakra
1 = Does Not Apply 3 = Applies Sometimes 5 = Applies All the Time
1 My body has difficulty regulating fluids (for example, I tend to urinate often; I am prone to swelling in my hands and ankles). 1 2 3 4 5
2 I've struggled to make money or to save it. 1 2 3 4 5
3 I have little interest in following through on ideas. 1 2 3 4 5
4 Eating fish is unappetizing for me. 1 2 3 4 5
5 I am an “emotional eater.” 1 2 3 4 5
6 I have suffered from a severe emotional trauma at some point in my life that I have difficulty overcoming. 1 2 3 4 5
7 I have allowed myself to be (emotionally, physically) abused by others. 1 2 3 4 5
8 I often feel guilty, especially about my food choices. 1 2 3 4 5
9 There is (are) relationships that I've been in that I have not been able to recover from. 1 2 3 4 5
10 (Women only) I have health issues with my reproductive organs (for example, uterus, ovaries). 1 2 3 4 5
11 I prefer being alone rather than being with others, or I cannot tolerate being alone. 1 2 3 4 5
12 I see myself as either an overly creative or noncreative person. 1 2 3 4 5
13 I have challenges around expressing my sexuality, or I express my sexuality too freely. 1 2 3 4 5
14 Conveying my emotions to others is difficult. 1 2 3 4 5
15 Commitment to a project or a relationship can be a challenge for me. 1 2 3 4 5
Sacral Chakra Total: ________
Section 3: Solar Plexus Chakra
1 = Does Not Apply 3 = Applies Sometimes 5 = Applies All the Time
1 Achievement of a goal is very important to me. 1 2 3 4 5
2 I exhaust myself by thinking too much. 1 2 3 4 5
3 I would call myself overstressed. 1 2 3 4 5
4 Saying “No” to people is difficult for me. 1 2 3 4 5
5 I don't do well when presented with many choices. 1 2 3 4 5
6 I crave high-energy foods to keep me going. 1 2 3 4 5
7 I would say that I am addicted to sugar. 1 2 3 4 5
8 I suffer from digestive complaints, mainly indigestion and bloating. 1 2 3 4 5
9 I need external substances (food, drugs, alcohol) to help me relax. 1 2 3 4 5
10 My weight fluctuates often. 1 2 3 4 5
11 I tend to be a perfectionist. 1 2 3 4 5
12 After I have been around other people, I feel drained of energy. 1 2 3 4 5
13 I lack self-confidence, or I have an inflated sense of confidence. 1 2 3 4 5
14 I find myself worrying about what others will think of me. 1 2 3 4 5
15 Most people would call me analytical, and maybe even critical. 1 2 3 4 5
Solar Plexus Chakra Total : _________
Section 4: Heart Chakra
1 = Does Not Apply 3 = Applies Sometimes 5 = Applies All the Time
1 My moods change often and I tend to be melodramatic. 1 2 3 4 5
2 I rarely have a chance to do what is best for me, or I tend to be overly selfish. 1 2 3 4 5
3 I neglect to eat green vegetables. 1 2 3 4 5
4 My hands get cold easily. 1 2 3 4 5
5 I am anxious. 1 2 3 4 5
6 Only select people are allowed to be close to me, physically or emotionally. 1 2 3 4 5
7 I have not felt true joy or happiness in recent years. 1 2 3 4 5
8 I feel shut down from my deepest feelings. 1 2 3 4 5
9 For the most part, my decisions are purely intellectual. 1 2 3 4 5
10 I have some form of heart disease (for example, atherosclerosis, arteriosclerosis, heart failure, heart attack, high cholesterol). 1 2 3 4 5
11 If I let myself cry, I feel that I may not be able to stop. 1 2 3 4 5
12 I lack passion for anything in life. 1 2 3 4 5
13 I find it difficult to touch or to be touched. 1 2 3 4 5
14 A traumatic event in my life has caused me to be unable to connect with my emotions. 1 2 3 4 5
15 I have issues receiving or giving love. 1 2 3 4 5
Heart Chakra Total: ________
Section 5: Throat Chakra
1 = Does Not Apply 3 = Applies Sometimes 5 = Applies All the Time
1 My verbal expression has been limited or excessive. 1 2 3 4 5
2 It is not my nature to speak up when I have been wrongfully accused. 1 2 3 4 5
3 I have chewing or swallowing difficulties. 1 2 3 4 5
4 Speaking my personal truth has not come easy. 1 2 3 4 5
5 My voice becomes raspy and my throat dry when I try to speak something I feel strongly about. 1 2 3 4 5
6 My metabolism is too slow or too fast. 1 2 3 4 5
7 Either I talk too much or I am afraid to speak for fear of being punished. 1 2 3 4 5
8 I have thyroid problems.