Health Quiz

This self-assessment is a tool for you to deepen your self awareness around your health. It may help highlight aspects of your health that you may not have given much attention to.

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HEAD Symptoms

Headache:

0 1 2 3 4

Faintness

0 1 2 3 4

Dizzy spells

0 1 2 3 4

Insomnia

0 1 2 3 4

EYES Symptoms

Watery/Itchy Eyes

0 1 2 3 4

Swollen, red or sticky eyelids

0 1 2 3 4

Bags or dark circles under eyes

0 1 2 3 4

EARS Symptoms

Itchy ears

0 1 2 3 4

Ear aches

0 1 2 3 4

Ringing in ears

0 1 2 3 4

History of ear infections

0 1 2 3 4

NOSE Symptoms

Stuffy nose

0 1 2 3 4

Sinus problems

0 1 2 3 4

Hay fever

0 1 2 3 4

Frequent colds

0 1 2 3 4

Loss of smell

0 1 2 3 4

MOUTH/THROAT Symptoms:

Chronic coughing

0 1 2 3 4

Frequent Sore throat

0 1 2 3 4

Canker sores

0 1 2 3 4

SKIN Symptoms:

Hives

0 1 2 3 4

Acne

0 1 2 3 4

Dry skin

0 1 2 3 4

Hair loss

0 1 2 3 4

Hot flashes

0 1 2 3 4

Eczema

0 1 2 3 4

HEART Symptoms :

Chest pain

0 1 2 3 4

Heart Murmur

0 1 2 3 4

LUNGS Symptoms

Cough

0 1 2 3 4

Asthma

0 1 2 3 4

Bronchitis

0 1 2 3 4

Wheezing

0 1 2 3 4

DIGESTIVE TRACT Symptoms :

Nausea

0 1 2 3 4

Diarrhea

0 1 2 3 4

Constipation

0 1 2 3 4

Bloated feeling

0 1 2 3 4

Burping

0 1 2 3 4

Passing gas

0 1 2 3 4

Intestinal or stomach pain

0 1 2 3 4

Heart burn

0 1 2 3 4

JOINTS/MUSCLE Symptoms

Pain or aches in joints

0 1 2 3 4

Arthritis

0 1 2 3 4

Stiffness or limitation of movement

0 1 2 3 4

Pain or aches in muscles

0 1 2 3 4

ENERGY Symptoms

Fatigue

0 1 2 3 4

Not waking rested after a full night’s sleep

0 1 2 3 4

3pm crash in energy

0 1 2 3 4

Need caffeine to get started

0 1 2 3 4

MIND Symptoms

Poor memory

0 1 2 3 4

Confusion

0 1 2 3 4

Poor comprehension

0 1 2 3 4

Poor concentration

0 1 2 3 4

Poor physical coordination

0 1 2 3 4

Difficulty in making decisions

0 1 2 3 4

EMOTIONS Symptoms

Mood swings

0 1 2 3 4

Anxiety

0 1 2 3 4

Fear

0 1 2 3 4

Overwhelm

0 1 2 3 4

Anger

0 1 2 3 4

Irritability

0 1 2 3 4

Aggressiveness

0 1 2 3 4

Depression

0 1 2 3 4

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