Stress
Please answer all of the following questions so we can determine your Stress Body Signals. Your analysis will be sent back to you via email.
Name
*
First Name
Last Name
Email
*
example@example.com
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Is your waist to hip ratio (WHR) greater than 0.90 (men) 0.85(women)* Waist ÷ Hip = Waist/Hip Ratio? (Waist ÷ Hip = Waist to Hip Ratio)
*
Yes
No
I don't know
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Do you have a jittery disposition or have a "short-fuse" or find that you are easily irritated or upset?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you get sick regularly (once a year or more)?
*
Never
Rarely
Sometimes
Often
Very Often
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Have you lost your motivation or feel unhappy?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you have a skin rash or pimple breakouts?
*
Never
Rarely
Sometimes
Often
Very Often
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Are you losing more hair than usual?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you have difficulty breathing?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you get frequent headaches?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you have, constipation, diarrhoea, stomach cramps, IBS, ulcers or Crohn's disease?
*
Never
Rarely
Sometimes
Often
Very Often
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Are you always tired but you get 7-8 hours sleep each night?
*
Never
Rarely
Sometimes
Often
Very Often
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Are you forgetful or unable to pick up new learnings as well as you used to?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you experience neck or back pain, twitching or trembling?
*
Never
Rarely
Sometimes
Often
Very Often
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Do you grind your teeth?
*
Never
Rarely
Sometimes
Often
Very Often
Total for all 12 Stress questions out of 40
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