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What SHAPE is Your Health In? Quiz
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What SHAPE is Your Health In? Quiz
What Shape Is Your Health In?
The What SHAPE is Your Health In? quiz is a great way to evaluate what SHAPE your health is in. Your results will steer you on the correct path towards better health. Share your results with your SHAPE practitioner. You can take this quiz as many times as you’d like to evaluate your progress on your healing journey.
Symptoms
Select the number that best describes how you have experienced each symptom over the last year:
Acid reflux, heartburn
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Acne
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Anxiety
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Asthma
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Belching, passing gas
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Bleed or bruise easily
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Bloating
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Blurred or tunnel vision
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Body odor
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Breast masses or fibroids
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Brittle Nails
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Bronchitis
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Brown age/liver spots
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Chemical sensitivities
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Chest congestion
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Chest pain or pressure
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Chronic coughing
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Cold/canker sores
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Constant sneezing
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Constipation
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Cravings
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Cysts, boils
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Depression
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Diarrhea
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Difficulty breathing
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Difficulty concentrating
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Difficulty falling/staying asleep
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Difficulty losing weight
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Dizziness, faintness
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Ear drainage
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Earaches, ear infections
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Eczema, psoriasis
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Erectile dysfunction
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Excessive sweating
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Excessive thirst/hunger
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Fatigue, low energy
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Food sensitivities/allergies
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Frequent colds or flus
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Frequent need to clear throat
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Gallbladder problems
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Gout
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Hair loss or thinning
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Hay fever, seasonal allergies
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Headaches, migraines
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Hemorrhoids
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
High blood pressure
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Hives
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Hot/cold intolerance
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Hyperactivity
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Incontinence
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Indigestion
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Insomnia
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Intestinal or stomach pain
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Irregular, skipped heartbeat
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Irregular periods
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Irritable when hungry
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Itchy ears
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Itchy skin, dermatitis
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Joint pain
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Kidney stones
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Low back pain
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Low blood pressure
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Low blood sugar
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Low libido
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Mood swings
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Muscle cramps, spasms
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Muscle pain, aches, weakness
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Nausea, vomiting
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Nose bleeds
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Painful or heavy periods
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Poor memory
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Premenstrual syndrome (PMS)
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Prostate problems
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Rapid or pounding heartbeat
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Skin rashes
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Shortness of breath
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Sinus congestion or infection
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Sore throat, hoarseness
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Stiffness, limited movement
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Stuffy nose
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Swelling, edema
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Swollen lymph nodes
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Swollen tongue, gums or lips
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Tendonitis, bursitis
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Tinnitus, hearing loss
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Ulcers
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Urinary tract problems
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Vaccine reactions
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Vaginal discharge
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Varicose veins
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Watery or itchy eyes
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Weight gain
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Yeast infections
Never
Occasionally
Frequent/Mild
Frequent/Moderate
Frequent/Severe
Always
Conditions
Have you ever been diagnosed with any of the following? Select one: (Yes or No)
ADD/ADHD
Yes
No
Anxiety
Yes
No
Arthritis
Yes
No
Asthma
Yes
No
Autoimmune conditions
Yes
No
Celiac disease
Yes
No
Colitis, Crohn’s disease
Yes
No
Depression
Yes
No
Diabetes
Yes
No
Eczema, psoriasis
Yes
No
Fibromyalgia
Yes
No
GERD
Yes
No
Gout
Yes
No
Gouty arthritis
Yes
No
Hay fever, seasonal allergies
Yes
No
Heart disease
Yes
No
Hepatitis, liver disease
Yes
No
Hypoglycemia
Yes
No
Infertility
Yes
No
Insulin resistance
Yes
No
Irritable bowel syndrome (IBS)
Yes
No
Restless leg syndrome (RLS)
Yes
No
Seizure disorder, epilepsy
Yes
No
Thyroid condition
Yes
No
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