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SPRING REFRESH INTAKE FORM
Wellness Intentions
How would you describe your overall health at the moment?
Have you ever seen an Ayurvedic Practitioner?
How would you describe your current digestive state?
How would you describe your metabolism?
How are your energy levels lately?
What is your current stress level?
How is the quality of your sleep in the last couple weeks?
Do you like to cook?
How would you describe your diet?
Are you currently pregnant or breastfeeding?
Do you use Birth Control?
How would you describe your cycle?
How would you describe your flow?
Digestion
Elimination
Sweating
Seasonal Allergies
Food Sensitivity
Apetite
Cravings
Skin
Mental-Emotional