1 --- 1 2 3 4 5 Do you maintain a healthy diet: low fat, low sugar, fresh fruits, grains and vegetables?
2 --- 1 2 3 4 5 Is your water intake adequate (at least ½ oz./lb. of body weight; 160 lbs. = 80 oz.)?
3 --- 1 2 3 4 5 Are you within 20 percent of your ideal body weight ?
4 --- 1 2 3 4 5 Do you feel physically attractive ?
5 --- 1 2 3 4 5 Do you fall asleep easily and sleep soundly?
6 --- 1 2 3 4 5 Do you awake in the morning feeling well rested?
7 --- 1 2 3 4 5 Do you have more than enough energy to meet your daily responsibilities ?
8 --- 1 2 3 4 5 Are your five senses acute ?
9 --- 1 2 3 4 5 Do you take time to experience sensual pleasure ?
10 --- 1 2 3 4 5 Do you schedule regular massage or deep-tissue body work ?
11 --- 1 2 3 4 5 Does your sexual relationship feel gratifying ?
12 --- 1 2 3 4 5 Do you engage in regular physical workouts lasting at least 20 minutes ?
13 --- 1 2 3 4 5 Do you have good endurance or aerobic capacity ?
14 --- 1 2 3 4 5 Do you breathe abdominally for at least a few minutes ?
15 --- 1 2 3 4 5 Do you maintain physically challenging goals ?
16 --- 1 2 3 4 5 Are you physically strong ?
17 --- 1 2 3 4 5 Do you do some stretching exercises ?
18 --- 1 2 3 4 5 Are you free of chronic aches, pains, ailments and diseases ?
19 --- 1 2 3 4 5 Do you have regular effortless bowel movements ?
20 --- 1 2 3 4 5 Do you understand the causes of your chronic physical problems ?
21 --- 1 2 3 4 5 Are you free of any drug or alcohol dependency (including nicotine and caffeine) ?
22 --- 1 2 3 4 5 Do you live in a healthy environment with respect to clean air, water and indoor pollution ?
23 --- 1 2 3 4 5 Do you feel energized or empowered by nature ?
24 --- 1 2 3 4 5 Do you feel a strong connection with and appreciation for your body, your home and your environment ?
25 --- 1 2 3 4 5 Do you have an awareness of life-energy or qi ?