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Yoga Sadhana Assessment Form

Do you face any physical health challenge which affects you in your day to day activities ? Select the option most applicable to you

Yes something troubles me all the time throughout the day
Yes it disturbs me everyday
Yes it disturbs many times, if not everyday
No there is nothing
Remarks :

Do you face any physical health challenge by which you are not affected in day to day life but concerned about

Yes if I neglect it can be of serious concern
Yes if I neglect it may cause some issue in future
Its not a concern but It is something which I want to improve
No there is nothing
Remarks :

How much of your attention is towards your physical body ?

I am always concerned about it anywhere anytime
Mostly I am not so concerned
I am concerned during special occasions
I am concerned when I have to be with people
Remarks :

How do you rate your food content input according to your body requirement ?

I am meticulous about what and how much I eat
I have decided to follow diet but unable to do so
I give myself liberty whenever I think I deserve
I eat whatever (including non-home) food and as much as I feel like
Remarks :

How much disciplined are you in following the right time for food ?

I dont follow any fixed time of eating
I want to but cant eat at regular time due to work and other issues
I have regular routine but cant say that it is healthy (eg daily late dinner)
I have regular healthy routine of eating
Remarks :

Do you know what enhances /depletes your energy ?

Yes I can sense the deviation in my energy / prana
I don't know about it, never gave any attention
I know I should be aware but miss it many times
I do not know completely but I know when I am in very low or very high energy
Remarks :

Are you aware of your Swara, ie the active nostril In breathing, and can you alter it?

No I am not aware of the swara
I am aware, and able to alter it sometimes
I am aware but I am not able to alter it
Yes I am aware, am able to work on it most of the times
Remarks :

Are you practising asana/ any other exercise/walk daily ?

Never
Intermittently, not regular
Regular at least 3/4 days a week
Always, everyday
Remarks :

Are you practising Pranayam everyday ?

No, I have not learnt properly
Intermittently, not regular
Regular at least 3/4 days a week
Everyday once/twice for 15 min or more
Remarks :

What is your average heart pulse ?

less than 65
65-80
80-90
more than 90
Remarks :

What is your number of breaths per minute ?

less than 10
10-15
15-20
more than 20
Remarks :

How do you rate yourself on the mental scale ? Patience/ Anxiety

I am mostly patient
Sometimes I am anxious
I am anxious many times
Remarks :

How do you rate yourself on the mental scale ? Trust/ Doubt

I tend to trust myself, everything and everyone
I trust after evaluation, sometimes I doubt myself too
I have a low self worth, always doubt my abilities
Remarks :

How do you rate yourself on the mental scale ? Peaceful / Disturbed

I am mostly peaceful in all situations
In stressful situations I get disturbed
Nowadays mostly I am disturbed - under stress
Remarks :

How do you rate yourself on the mental scale ? Fast / Slow

I am a fast thinker
I am fast in thinking in some areas
I know I am slow in thinking
Remarks :

On the following characteristic traits how do you rate yourself ? Simple / Complex

I am known to be simple in my thinking and behaviour
In some relationships/situationsI am complex
People find me as a complex person
Remarks :

On the following characteristic traits how do you rate yourself ? Humour

I catch humor very fast
I like humor which is easy to understand
Many times I dont get the jokes
Remarks :

On the following characteristic traits how do you rate yourself ? Creativity

I generally try to find novel ways of doing everything
I am creative in my selected area
I generally follow the given norms
Remarks :

Generally how do you find your state of mind on following parameters ? Happy / Sad

I am generally happy in most situations
I am happy in selected situations with some people
I mostly tend to brood as I find myself filled with sadness
Remarks :

Generally how do you find your state of mind on following parameters ? Balance

I find myself balanced in most situations
There are some situations in which I lose my balance
I get agitated fast
Remarks :

What is true about yourself from the following sentences - tick wherever most applicable

In personal life, I have an ability to perceive risks about everything in life, and I take care of all the risks
I am a good trouble shooter, and generally I tend to solve problems any how when they arrive
While caring for myself and my family, I do care about others and help them whenever I can
I keep myself away from any trouble causing situation
I can sense opportunity and use it to provide to provide help to people around me
Everything is alright and all is going on as it should be
I am not bothered about security in life, because right things happen to me/ come to me at right time always
I keep the basic minimum for myself and family, and use the rest to provide for others
Remarks :

What is true about yourself from the following sentences - tick wherever most applicable

World is a place of fun, you should know how to enjoy
I dont see anything around me which I can enjoy, or inspire me, my appetite is low
I dont believe in hollow happiness, first I tackle the negative factors
I keep myself happy with good food, drink and things. There is no harm in indulging in things as long as it keeps me happy
I am generally happy from inside, so wherever I go generally things cheer up
For me it is important to make people around me happy, to be happy myself
People say I have charismatic personality, I generally see positive side of people
I have find myself in the state of bliss
Remarks :

What is true about yourself from the following sentences - tick wherever most applicable

I believe in doing things myself, and try hard to complete it, not get stuck by emotions
I generally dont see the need to do anything & don’t have energy or motivation to change things
I prefer to pick on small jobs, because I cant continue on same thing for long time
I work for good cause, for any person or organization, even if sometimes it may mean no reward
The larger power gets everything done with its infinite consciousness, I don’t have any role
I like to win, and I have the knack of winning over any opposition
I believe I am a serving instrument in whatever I am doing
I believe in doing things for a larger purpose with no attachment to rewards
Remarks :

What is true about yourself from the following sentences - tick wherever most applicable

I am good at making friends with anyone if I need to
I generally don't see the need to care for other's feelings, why should I ?
I can go all out for someone who loves me
I feel love for all, look for opportunities and think of ways to help them
I have few friends for whom I care as long as they follow the rules of our group / company/ orgn / etc
I have faith in the cosmic love and it flows through all beings
I love my family, friends & care for them
Usually I find wherever I go, whomever I am with, the anomisities dissolve and people find love
Remarks :

What is true about yourself from the following sentences - tick wherever most applicable

Assessment is fine, but there are too many questions, can you do something smaller ?
I am told that generally I dominate the conversations
I like to be alone, even if I am in crowd, I prefer to be by myself
I can connect easily wth people, and explain difficult things easily, with my words and my body language
What is there to talk, everybody else is doing the talking, I am a good listener
Even a word spoken by me is transmitted to the entire cosmos, so I care about what I speak
Words out smoothly when I speak, without efforts, and all seem to hear and agree to what I say
I can read minds of people while speaking so I care about what I speak
Remarks :

What is true about yourself from the following sentences - tick wherever most applicable

I am a normal human being who thinks about family and friends. I do my work to me best abilities
I am more interested in action rather than thinking, because somehow I cant think
I am good at selling, can sense opportunities and convince people
I am attracted to knowledge, and tend to use it constructively and ethically. I respect intelligence
I am scared to speak to intelligent people, so I pretend and act stupid, so that people don’t place too many demands on thinking
The understanding of the multidimensional consciousness and energy through which I understand all is difficult to be articulated here
I tend to think out of the box, creatively, and people around me are generally amazed at it
Often I have access to intuition and higher wisdom, which helps others
Remarks :

What is your attitude towards FOOD ?

I eat to enjoy food
Eating is my offering to the body
I eat to take care of my body needs
I eat so that my body serves me well
Remarks :

What is your attitude towards Sleep rest ?

I love to sleep and find opportunities to sleep whenever I can
I sleep enough to give necessary rest to my body
I sleep to get in touch with the higher self within me
I sleep as much as required so that I can work to me best capacity
Remarks :

What is your attitude towards Work ?

I work as it needs to be done
I work to earn
I work because I enjoy doing it
I work to liberate myself from bondage
Remarks :

What is your attitude towards Recreation & Entertainment ?

I seek realization by renouncing mortal pleasure and seek spiritual satisfaction
I involve myself in a hobby to keep my mind fresh
I look forward to pleasurable moments
I need a break from work routine so I entertain myself
Remarks :

What is your attitude towards Exercise / Yoga ?

I cant stay without Yoga/Exercise, I feel uncomfortable whenever I miss
Through Yoga I seek liberation from body mind attachment and move to higher goals
I do Yoga/Exercise because it is my responsibility to keep my body and mind in good health
My body is my instrument, so I have to keep it in good condition so that it gives best output
Remarks :

What is your attitude towards Friends and Relations ?

Friends and Relatives are my mirror for self development
I look forward to happy moments with friends and relatives
I always support my friends and relatives
I rely on Friends and Relatives when in trouble
Remarks :
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