What are Chakras?

Chakra essentially means ‘wheel’. When our energy chakras or ‘wheels’ are in balance, they spin like a vortex. When someone is under physical or mental stress, the energy chakras become stagnant or blocked, but they may also speed up or slow down, becoming imbalanced and can affect the body-mind-spirit.

This questionnaire is to determine which areas to focus on for balancing your energy chakras. It is important to be honest and thorough when filling it out in order to properly determine imbalances in chakras. The questionnaire is for your own personal use.

Provided are short description of each chakra and its associations and possible imbalances to better understand them better.

Root (1st) Chakra- Located at Base of Spine/Perineum
Color: Red
Characteristics: Survival, Security, Grounding, Home, Health and Vitality
Physical Associations: Constipation, Obesity, Arthritis, Feet & Legs, Low Stamina, Spine, Adrenal Glands, Kidneys
Signs of Imbalance: Fear, Insecurity, Instability, Possessiveness, Disconnected from Body, Weight Issues, Materialistic

Sacral (2nd) Chakra- Located at Lower Abdomen/Pelvic Region
Characteristics: Sex and Reproduction, Desire and Pleasure, Creativity, Personal Relationships
Physical Associations: Urinary and Reproductive systems, Lower Back, Fluids in Body
Signs of Imbalance: Sexual Problems, Lack of Enthusiasm, Addictions, Mood Swings

Solar Plexus (3rd) Chakra- Located at Mid Abdomen
Characteristics: Identity & Individuality, Personal Power, Self-Worth, Will Power, Social Relationships
Physical Associations: Digestive System and Sugar Balance, Metabolism and Heat Regulation, Mid-Back
Signs of Imbalance: Weak-Willed, Stubborn, Unreliable, Manipulative, Addicted to Approval, Lacking Self-Confidence, Struggle, Inability to Express Anger, Hyperactive, Judgmental of Self and Others

Heart (4th) Chakra- Located at Chest
Characteristics: Love, Compassion, Concern For Others, Intimacy, Nurturing, Artistic Enjoyment
Physical Associations: Circulatory system and Lungs, Breasts, Upper Back, Hands & Arms, Touch, Thymus Gland, Immune System
Signs of Imbalance: Attachment, Greed, Jealousy, Depression, Auto-Immune Issues, Anti-Social Feelings, Fear of Intimacy, Overly Sensitive

Throat (5th) Chakra- Located at Throat
Characteristics: Expression, Communication, Creativity, Honesty, Organization of Time, Rational Thought
Physical Associations: Bronchi, Vocal Chords, Mouth, Thyroid and Parathyroid Glands
Signs of Imbalance: Shyness, Fear of Public Speaking, Talking Too Much or Too Little, Dishonesty, Vertigo, Rushed

Third Eye (6th) Chakra- Located at Forehead Between Eyes
Characteristics: Intellectual and Intuitive Understanding, The Subconscious, Dreams, Memory, Imagination, Idealism
Physical Associations: Brain, Eyes, Ears, Sense of Smell, Nervous System, Pituitary Gland
Signs of Imbalance: Headaches/Migraines, Forgetfulness, Nightmares, Sleeplessness, Heady, Difficulty Concentrating, Out of Touch With Reality

Crown (7th) Chakra- Located at top of Head
Characteristics: Connection with The Divine, Higher Consciousness, Self-Knowledge, Spirituality
Physical Associations: Pineal Gland, Brain, Central Nervous System
Signs of Imbalance: Lack of Purpose In Life, Fear of Death, Coma, Epilepsy

* Please read: Please mark all that apply for each question. Take your time and be as honest as possible. When you are done, add up all selected for each corresponding # and place into provided total lines.

1. Which area(s) of your body concern you?
1___ Feet & Legs
2___ Between Waist & Hips
3___ Waist
4___ Chest
5___ Neck & Shoulders
6___ Face
7___ Head

2. Which area(s) of your body do you dislike?
1___ Feet & Legs
2___ Between Waist & Hips
3___ Waist
4___ Chest
5___ Neck & Shoulders
6___ Face
7___ Head

3. Which area(s) of your body are you proud of?
1___ Feet & Legs
2___ Between Waist & Hips
3___ Waist
4___ Chest
5___ Neck & Shoulders
6___ Face
7___ Head

4. Which area(s) of your body are affected by major health issues?
1___ Feet & Legs
2___ Between Waist & Hips
3___ Waist
4___ Chest
5___ Neck & Shoulders
6___ Face
7___ Head

5. Which area(s) of your body are affected by minor health issues?
1___ Feet & Legs
2___ Between Waist & Hips
3___ Waist
4___ Chest
5___ Neck & Shoulders
6___ Face
7___ Head

6. Which colour(s) do you like the most?
1___ Red
2___ Orange
3___ Yellow
4___ Green
5___ Blue
6___ Dark Blue
7___ Violet

7. Which colour(s) do you like the least?
1___ Red
2___ Orange
3___ Yellow
4___ Green
5___ Blue
6___ Dark Blue
7___ Violet

8. Which are your favourite food(s)?
1___ Meat/Fish/Proteins
2___ Rice/Orange Fruits
3___ Wheat/Yellow Fruits
4___ Green Fruit & Vegetables

9. Which type of exercises/activities interest you the most?
1___ Fast Action
2___ Dancing/Painting
3___ Crosswords/Puzzles
4___ Anything Outdoors
5___ Drama/Singing
6___ Mystery/Crime Novels
7___ Doing Nothing

10. What sort of people do you look up to/admire?
1___ Sports Athletes
2___ Artists/Musicians
3___ Intellectuals
4___ Conversationalists
5___ Speakers/Politicians
6___ Inventors
7___ Mystics/Religious Figures

11. What sort of person do you think yourself as?
1___ Get on with things
2___ Creative
3___ Thinker/Worker
4___ Emotional
5___ Chatterbox
6___ Quiet
7___ Daydreamer

12. What emotional characteristics do you consider are most frequent in your life?
1___ Passionate
2___ Easy-going
3___ Contented
4___ Caring, Sharing
5___ Loyal
6___ Helpfully Distant
7___ Sympathetic

13. What emotions do you have that you would like to change?
1___ Temper
2__ Possessiveness
3___ Confusion
4___ Insecurity
5___ Needing things to be ‘black & white’
6___ Feeling separate from others
7___ Not saying ‘No’

14. If you get angry, what is your most common reaction?
1___ Rage/Tantrums
2___ Sullen Resentment
3___ Get Frightened
4___ Blame Yourself
5___ Keep Quiet
6___ Withdraw
7___ Pretend Nothing Happened

15. What are you most afraid of?
1___ Dying
2___ Lack of Sensation
3___ Things you don’t understand
4___ Being Alone
5___ Having no one to talk to
6___ Losing your way
7___ Difficult Decisions

16. Which of these describes the way you tend to learn?
1___ Fast
2___ Slowly
3___ Quick but forget
4___ Through feelings/hands-on
5___ Repetitiveness
7___ Can’t be bothered

17. What best describes your reaction to situations?
1___ Enthusiastic
2___ Go with the flow
3___ Think things through
4___ See how things feel
5___ Ask a lot of questions
6___ See the patterns then act
7___ Drift along without care

18. If you are criticized or reprimanded, what is your usual response?
1___ Anger
2___ Resentment
3___ Fear
4___ Self-Blame
5___ Verbal Riposte
6___ Think about it
7___ Denial

19. How would you describe your favourite books/films/video games?
1___ Combat/Action
2___ Art
3___ Skill, Intellectual
4___ Romances
5___ Dramas
6___ Detective Stories/Suspense
7___ Spiritual/Self-Development

Count up the total of each #: 

1's _____                

2's _____          

3's _____ 

4's _____                

5's _____ 

6's _____

7's _____


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