Questionnaire for Bach Flower Remedy

Name:

DOB:

Age:                            

Gender: M / F        

Date:

Address:

Contact No:                          

Email Id:

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Please answer the following questions as honestly as possible after carefully evaluating the question. The accuracy of the answers will help us identify the most appropriate combination of remedy for you.

The questions are no way designed to assess the character or morals of the individual are exclusively for diagnostic purposes only.

Please be reassured that the confidentiality of the data provided, will be kept by the Bach Flower Therapist without any judgment. 

 

 

Write YES in CAPS and BOLD against the one, which is applicable. eg.YES/ often / sometimes/ rarely/ Never

 IMPORTANT: IGNORE IF NOT APPLICABLE

Request: Please do not answer the questions in a hurried manner and rush to fill up the questionnaire in a single sitting. Take your time. Pause for a few moments with each question and check with yourself before replying This is the most crucial factor. Preferably answer only 10 to 12 questions in a sitting at a time.  Maybe answer only 1 page at a time. Come back to it a later. Answer only if it is YES/ often / sometimes/ rarely/ Never. 

 

 

 

 

The efficacy of the remedy has been tried, tested and proven over twenty years on hundreds of patients with great success by Dr. Gulshan Thukral [provided the guidelines/dosage/duration and frequency are adhered to and followed as advised]

There is no restriction of any kind. In exceptional cases alteration in diet and life style may be required for speedy results. 

Reminder:- IGNORE IF NOT APPLICABLE 

 

1. Do you conceal your internal mental torture behind the façade of a care-free and cheerful face whilst weeping inside and laughing outside? YES / often / sometimes /    rarely / Never   

 Do you have a turbulent state of mind? YES/ often / sometimes / rarely/ Never      

 Do you seek excitement the consequences of which can be dangerous and may bring harm? YES/ often / sometimes / rarely / Never

Do you feel restless at night which is caused by churning thoughts? YES / often / sometimes / rarely/ Never

Do you dislike being alone and are seeking companionship in order to escape and forget worries? YES / often / sometimes / rarely / Never

When you feel stressed out, do you resort to alcohol or drugs? YES / often / sometimes / rarely / Never                       1. Ref: Agrimony / 6

 

2. Do you have fears and apprehensions? YES/ often / sometimes/ rarely/ Never

Do you have unfounded fears? YES/ often / sometimes/ rarely/ Never

Do you have fears without any rhyme or reason at any time of day and night? YES/ often / sometimes/ rarely/ Never

Are you mortally afraid and you do not know from what? YES/  often / sometimes/ rarely / Never                                   2. Ref: Aspen / 4

 

3. Do you easily criticize and condemn without making any allowance for even the genuine difficulties of others? YES / often / sometimes / rarely/  Never

Are you sympathetic to others? YES / often / sometimes / rarely / Never

Are you humble? YES / often / sometimes / rarely / Never                                                                                             3. Ref: Beech / 4

4. Do you find it difficult to say no to anybody or for anything, hence and you land up doing other people’s jobs for them? Because you cannot refuse others use you as door-mat. You feel that you have no choice except to obey orders? YES / often / sometimes / rarely / Never                                                                                                                                                        4 Ref: Centaury / 2

 

5. Do you distrust your own judgment? YES/ often / sometimes/ rarely/ Never

Do you doubt your own abilities? YES/ often / sometimes/ rarely/ Never

Do you fail to be guided by inner voice? YES / often / sometimes / rarely / Never

 Do you ask for other’s opinion about your personal problems? YES/ often / sometimes / rarely / Never

Are you confused on getting your conflicting views and usually opt for the wrong choice, then laments after discovering that your own judgement was after all correct. Meanwhile you have made a nuisance of yourself by asking frivolous questions from others? YES/ often / sometimes/ rarely/ Never

Do you distrust your own convictions? YES/ often / sometimes/ rarely/ Never

Are you very talkative, always asking questions? YES/ often / sometimes/ rarely/ Never

Do you tend to sap vitality of others by seeking advice? YES/ often / sometimes/ rarely/ Never

Do you have tendency to imitate? YES/ often / sometimes/ rarely/ Never                                                                5.Ref: Cerato / 10

 

6. Do you feel desperate? YES/ often / sometimes/ rarely/ Never

Do you fear losing your mind over your actions? YES/ often / sometimes/ rarely/ Never

You can do anything-even kill some body or kill yourself at the spur of the moment, without thinking? YES/ often / sometimes/ rarely/ Never

Do you have an unbearable condition of mind? YES/ often / sometimes/ rarely/ Never

Do you act on impulse than on reason? YES/ often / sometimes/ rarely/ Never

Do you feel you are on the verge of nervous breakdown? YES/ often / sometimes/ rarely/ Never

     Do you feel you are almost hysterical and do you feel you can shout for help? YES/ often / sometimes/ rarely/ Never

     Do you have fear of suicide? YES/ often / sometimes/ rarely/ Never

     Do you feel your mind will give way to doing fearful things? YES/ often / sometimes/ rarely/ Never

     Do you have the fear of losing control and reason? YES/ often / sometimes/ rarely/ Never

     Do you have fear of insanity? YES/ often / sometimes/ rarely/ Never

Do you feel it is possible that you act on violent impulses / sudden murderous actions? YES/ often / sometimes/ rarely/ Never                                 6. Ref: Cherry Plum / 12

 

7. Are you inattentive to what is happening around you? YES/ often / sometimes/ rarely/ Never

Do you repeat the same mistakes again & again; do not learn from past experiences? YES/ often / sometimes/ rarely/ Never  

Are you absent minded, prone to road accidents etc.? YES/ often / sometimes/ rarely/ Never

Do you compulsively repeat of what has already been told? YES/ often / sometimes/ rarely/ Never

Do you try to forget the past but have no guide to help you in the now or the future? YES/ often / sometimes/ rarely/ Never                                                                                                7.Ref: Chestnut Bud / 5

8. Do you think only about yourself? YES/ often / sometimes/ rarely/ Never

Do you always keep self-interest in view? YES/ often / sometimes/ rarely/ Never

Are you possessive? YES/ often / sometimes/ rarely/ Never

Do you have a lot of expectations from others? YES/ often / sometimes/ rarely/ Never

 Do you feel bad if you do not get full attention? YES/ often / sometimes/ rarely/ Never

 Do you always want to get/to receive/ and to possess, never want to give? YES/ often / sometimes/ rarely/ Never

Do you feel hurt / offended / rejected? YES/ often / sometimes/ rarely/ Never

Do you require to confirm your higher sense of values especially with your near and dear ones? YES/ often / sometimes/ rarely/ Never

Are you interfering by nature? YES/ often / sometimes/ rarely/ Never

Are you constantly inattentive? YES/ often / sometimes/ rarely/ Never

Do you talk of duties owed to you? YES/ often / sometimes/ rarely/ Never

Do you become fretful, even tearful when thwarted? YES/ often / sometimes/ rarely/ Never

Do you dislike being alone? YES/ often / sometimes/ rarely/ Never

Are you selfish / deceitful / strong willed / talkative / irritable? YES/ often / sometimes/ rarely/ Never

Do you enjoy arguments? YES/ often / sometimes/ rarely/ Never                                                                8.Ref: Chicory / 15

9. Are you inattentive, is your mind far removed from the actual physical surroundings, pre-occupied with a vacant far away look and totally indifferent to what is happening around you? YES/ often / sometimes/ rarely/ Never

Do you live more in dreams even when you are awake? YES/ often / sometimes/ rarely/ Never

Do you feel very drowsy? YES/ often / sometimes/ rarely/ Never

Are you a heavy sleeper? YES/ often / sometimes/ rarely/ Never

Do you easily fall asleep at any time? YES/ often / sometimes/ rarely/ Never

Do you prefer to be alone? YES/ often / sometimes/ rarely/ Never

Do you avoid difficulties by withdrawing from them? YES/ often / sometimes/ rarely/ Never                                       9.Ref: Clematis / 7

10. Do you want to throw away anything. which is unclean or which is undesirable? (Either from the body or from the mind) YES/ often / sometimes/ rarely/ Never

Do you want to disposess yourself of any unclean thought, any unpleasant sensation and even any ugly part of your body? YES/ often / sometimes/ rarely/ Never

Are you ashamed of your physical condition or appearance? YES/ often / sometimes/ rarely/ Never

If you are undergoing any treatment and the treatment fails do you feel despondent? YES/ often / sometimes/ rarely/ Never

Are you fussy? YES/ often / sometimes/ rarely/ Never

Are you house-proud? YES/ often / sometimes/ rarely/ Never                                                                                     10.Ref: Crab Apple / 6

11. Do you have the sudden feeling of being overwhelmed by responsibilities and feel inadequate about them? YES/ often / sometimes/ rarely/ Never

There are some weak moments in the lives of even the strong. Even the most capable and efficient people holding most responsible position in society are some times so weighed down by the amount of work they are supposed to accomplish, that they feel exhausted and a feeling of inadequacy assails them. Do you feel the same? YES/ often / sometimes/ rarely/ Never                               11-Ref: Elm / 2

 

12. Do you have doubts? YES/ often / sometimes/ rarely/ Never

Are you depressed? YES/ often / sometimes/ rarely/ Never

Do you lack faith? YES/ often / sometimes / rarely / Never

You don’t feel optimistic? YES/ often / sometimes / rarely / Never                                                                                    

Do you always look at the dark side of the case? Always call a half bottle empty, never call it half full? YES/ often / sometimes / rarely / Never

You are depressed but cannot identify the cause? YES/ often / sometimes / rarely / Never

Are you unduly discouraged due to a set- back during convalescence? YES/ often / sometimes/ rarely/ Never

Are you easily discouraged when things go wrong or when there are difficulties? YES/ often / sometimes/ rarely/ Never

Do you find it hard to believe that it’s one’s own lack of faith and understanding, that prevents overcoming problems? YES/ often / sometimes/ rarely/ Never                                                                                                                               12-Ref: Gentian / 9

13. Do you feel hopeless? E.g. When a patient is fed up with a long treatment of a chronic disease and has been either told by the doctor that his disease is incurable or has himself come to the same conclusion, he becomes thoroughly depressed. Although he may continue with some treatment on the persuasion of some well wishers, he himself is dejected, and has lost all hope to recover his health. YES/ often / sometimes / rarely / Never

Do you continue to bear pain and suffering, which you are convinced that, it is due to inherited conditions? YES/ often / sometimes/ rarely/ Never

Do you feel it is useless to try different conditions? YES/ often / sometimes/ rarely/ Never                          13 Ref: Gorse / 3

 

14. Are your thoughts centered on yourself? YES/ often / sometimes/ rarely/ Never

Are you always concerned with your own problems? YES/ often / sometimes/ rarely/ Never

Are you always talking of your own ailments? YES/ often / sometimes/ rarely/ Never

Are you weepy sometimes? YES/ often / sometimes/ rarely/ Never

Do you tend to go close and speak into others face? YES/ often / sometimes/ rarely/ Never

You have no time to listen to others? YES/ often / sometimes/ rarely/ Never

Do you tend to exaggerate, eg. making mountain out of molehills? YES/ often / sometimes/ rarely/ Never

Do you make a nuisance of yourself, forcing others to listen to your constant prattle? YES/ often / sometimes/ rarely/ Never

Do your friends shun you? YES/ often / sometimes/ rarely/ Never

Do you become desperate when left alone without any listener? YES/ often / sometimes/ rarely/ Never            14 Ref: Heather / 10

 

15. Do you have hatred / jealousy? YES / often / sometimes / rarely /  Never

Do you envy distrust, the very antithesis of love? Not only man, but even a child becomes jealous of his younger brother or sister when he has to share his parents love with him-the love which was exclusively showered on him previously. Even a pet dog in the family shows resentment when a new baby arrives in the family. YES / often / sometimes/ rarely/ Never

Are you suspicious? YES / often / sometimes/ rarely/ Never

Are you aggressive? YES / often / sometimes / rarely / Never

Is greed one of your weaknesses? YES / often / sometimes / rarely / Never

Do you lack emotional love n your life? YES/ often / sometimes/ rarely/ Never

Do you often have misunderstanding with people? YES/ often / sometimes/ rarely/ Never

Do you have a bad temper? YES/ often / sometimes/ rarely/ Never

Do you get angry towards your fellow men? YES/ often / sometimes/ rarely/ Never

Do you suffer often without a cause? YES/ often / sometimes/ rarely/ Never

Do you get irritated easily? YES/ often / sometimes/ rarely/ Never

Do you like to take revenge if someone s hurt you or upset you? YES/ often / sometimes/ rarely/ Never              15 Ref: Holly / 13

 

16. Do you always think of the past? YES/ often / sometimes/ rarely/ Never

Do you talk of the past events-or life in the past? YES/ often / sometimes/ rarely/ Never

Are you unable to break contact with the past events? YES/ often / sometimes/ rarely/ Never

Do you have regrets and remorse for the past events? YES/ often / sometimes/ rarely/ Never

Do you find it difficult to live in the present, and make no effort to solve the present difficulties? YES/ often / sometimes/ rarely/ Never

When a difficult situation arises, you escape to the past, as if the present does not belong to you? YES/ often / sometimes/ rarely/ Never

Are you not able to get over the loss of a person one loved (parent, child, spouse, or friend)? YES/ often / sometimes/ rarely/ Never

Do you feel home sick (away from home)? YES/ often / sometimes/ rarely/ Never

Are you fearful about the future? YES/ often / sometimes/ rarely/ Never

Do you tend to lose interest in the present? YES/ often / sometimes/ rarely/ Never

Do you tire easily? YES/ often / sometimes/ rarely/ Never

Are you a widow / orphan? YES/ often / sometimes/ rarely/ Never

Have you failed in business? YES/ often / sometimes/ rarely/ Never

Do you have to live alone? YES/ often / sometimes/ rarely/ Never                                                         16. Ref: Honeysuckle / 14

 

17. Do you have mental weariness? YES/ often / sometimes/ rarely/ Never

Do you feel tired and exhausted even before you have started the work? YES/ often / sometimes/ rarely/ Never

Do you wake up in the morning but feel too weak to leave the bed? YES/ often / sometimes/ rarely/ Never

Do you visualize that work makes you feel weak and exhausted, but once you start doing the work, you accomplish it without difficulty.

However, this mental lethargy is the cause of your feeling of weakness. YES/ often / sometimes/ rarely/ Never

You feel more tired in the morning after night’s rest than in the evening after day’s labour. YES/ often / sometimes/ rarely/ Never

Are you a convalescent and have doubts about your recovery? YES/ often / sometimes/ rarely/ Never

Do you hate to go to work on Monday morning? YES/ often / sometimes/ rarely/ Never                                     17 Ref: Hornbeam / 8

 

18. Are you impatient in all walks of life-in thought, in action, in temper, very quick in thinking, in deciding, in action, in speaking, in eating? YES/ often / sometimes/ rarely/ Never

Do you find it difficult to tolerate slow or even normal speed of others? YES/ often / sometimes/ rarely/ Never

Would you snatch a piece of work from another worker to finish it quickly? YES/ often / sometimes/ rarely/ Never

Does your anger, although it flares up quickly, subsides also quickly? YES/ often / sometimes/ rarely/ Never

Are you as a boss/ instructor popular amongst your subordinates or trainees? YES/ often / sometimes/ rarely/ Never

Are you very restless when waiting in queue outside doctor’s clinic, on bus stop or on railway station? YES/ often / sometimes/ rarely/ Never

Do you have a “Quick temper”? YES/ often / sometimes/ rarely/ Never

Do you get irritated? YES/ often / sometimes/ rarely/ Never

Do you get nervous? YES/ often / sometimes/ rarely/ Never

Do you like to be like others? YES/ often / sometimes/ rarely/ Never

Do you prefer to work alone? YES/ often / sometimes/ rarely/ Never                                                               18. Ref: Impatiens / 11

 

19. Do you have complete lack of self-confidence? YES/ often / sometimes/ rarely/ Never

Generally you are so sure of your failure, hence you do not even attempt to give a try? YES/ often / sometimes/ rarely/ Never

You are quite capable of undertaking any work, but do not dare to do due to fear of failure? YES/ often / sometimes/ rarely/ Never

You are able to appreciate and even feel happy at other’s success (without rancor, jealousy or envy) but would not try to do the same thing due to lack of confidence? YES/ often / sometimes/ rarely/ Never

Inwardly do you want to be like others? YES/ often / sometimes/ rarely/ Never

You are very capable of doing the work, but the pre-conceived surety of failure prevents you from undertaking the work? YES/ often / sometimes/ rarely/ Never

Do you have inferiority complex? YES/ often / sometimes/ rarely/ Never                                                                    19 Ref: Larch / 7

 

20. Do you have fear of anything – fear of dogs/ snake/ accidents/illness/dampness/cold/death/ of cancer, of any person or ghost/ fear of examination/ fear of poverty/ fear of losing friends/ afraid of walking in the dark/fear of public speaking etc? YES/ often / sometimes/ rarely/ Never

This list of fears is inexhaustible. There is only one proviso-the fear has to be of any thing which is known and which can be named? YES/ often / sometimes/ rarely/ Never

Are you nervous? YES/ often / sometimes/ rarely/ Never

Are you sensitive in nature? YES/ often / sometimes/ rarely/ Never

Do you stammer? YES/ often / sometimes/ rarely/ Never

Do you blush? YES/ often / sometimes/ rarely/ Never

Does your throat suddenly choke in presence of strangers? YES/ often / sometimes/ rarely/ Never

Do you tend to start talking fast out of sheer nervousness although you are normally quiet? YES/ often / sometimes/ rarely/ Never                                20 Ref: Mimulus / 8

 21. Do you get suddenly depressed which descends like a cloud and envelops you without any warning, leaving you thoroughly distressed? The cloud lifts after sometime by itself as suddenly as it came. You do not know when it would come, how long it would last and when it would come again. So long this depression lasts, you are thoroughly non–plussed, with beads of sweat covering your face and forehead, anxiety writ large on your face and hair standing on edge, anybody can see that you are unwell, but if asked what is the matter with you, you would invariably say “Oh, nothing, I am alright”. Does all or any of the above sound very familiar & pretty close to what you go through or experience? YES/ often / sometimes/ rarely/ Never

Do you sometimes, also experience some moments when without any reason, you have a fit of depression and nothing gives you any joy? YES/ often / sometimes/ rarely/ Never                                                                                                                21. Ref: Mustard / 2

22. Do you have a “NEVER GIVE UP” attitude in life? YES/ often / sometimes/ rarely/ Never

Do you never give up hope and continue to work against all odds? YES/ often / sometimes/ rarely/ Never

Like an oak tree, you stand strong and hold your ground against the most difficult weather conditions. You may get tried, despondent and discouraged by your failures. Your well –wishers and the experts may advise you to discontinue your pursuit. Your doctor may tell you that his case is hopeless, but you would not lose hope and would not give up. YES/ often / sometimes/ rarely/ Never

However, with all the attributes of the winner i.e. tremendous will-power, invincible power of resistance, super human endurance, courage, faith and hope, if you let endurance become an aim in itself, and do not allow your body a moment’s rest from the ceaseless physical strain, you end up as a loser with a nervous collapse, with physical rigidity, and loss of flexibility. YES/ often / sometimes/ rarely/ Never

Does this apply to you? YES/ often / sometimes/ rarely/ Never

Do you overwork and hide tiredness? YES/ often / sometimes/ rarely/ Never

Are you very stubborn / obstinate? YES/ often / sometimes/ rarely/ Never

Are you brave/ reliable / strong/ patient? YES/ often / sometimes/ rarely/ Never

Do you fight adversity/ difficulties /illness without loss of hope? YES/ often / sometimes/ rarely/ Never

Do you look for all kinds of cures or remedies when unwell without loss of hope? YES/ often / sometimes/ rarely/ Never

22 Ref: Oak / 10

 

23. Do you have complete exhaustion of body and mind, unable to do any further work due to fatigue? YES/ often / sometimes/ rarely/ Never

Are you tired physically, having done lot of manual work? YES/ often / sometimes/ rarely/ Never

Are you tired mentally after having done lot of brainwork or “fed up” having done uninteresting and monotonous work for some length of time? YES/ often / sometimes/ rarely/ Never

Are you drained of all strength after prolonged sickness with restricted or unbalanced diet: after lack of sleep attending to a sick relative and after continuous working overtime after, office hours? YES/ often / sometimes/ rarely/ Never

Have u been undergoing hardship from a long time? YES/ often / sometimes/ rarely/ Never

Your lifestyle is so busy that you have very little time for relaxation and enjoyment? YES/ often / sometimes/ rarely/ Never

You are no longer able to enjoy work or things that used to give pleasure and interest? YES/ often / sometimes/ rarely/ Never      

 23.Ref: Olive / 7

 

24. Do you condemn yourself? YES/ often / sometimes/ rarely/ Never

Do you feel guilty about certain things? YES/ often / sometimes/ rarely/ Never

Do you blame yourself even for the faults of others? YES/ often / sometimes/ rarely/ Never

Are you over-conscientious: always try to improve your work, and never satisfied with your own achievements? YES/ often / sometimes/ rarely/ Never

Do you tend to overwork? YES/ often / sometimes/ rarely/ Never

Even when trying your best to improve the lot of your fellow men, if you fail, you would still blame yourself for not doing enough in your noble mission. You are, so to say, always on the look out for an excuse to blame yourself? YES/ often / sometimes/ rarely/ Never

Are you never happy? Is it that you are allergic to happiness? YES/ often / sometimes/ rarely/ Never                        24. Ref: Pine / 7

 

25. Do you have fear and over-anxiety for others? The fear may be justifiable, as of parents whose young child has left the village school to live in a college hostel in a city, the fear that the child may not fall in bad society, or the fear about a relative who was traveling in a train, which has met with an accident. The fear may be unfounded as of a doting mother who feels worried about her child and becomes restless hours before the return of his school bus. YES/ often / sometimes/ rarely/ Never

Do you fear or have apprehension about others? YES/ often / sometimes/ rarely/ Never

Do you fear calamity befalling on them- the worst possible? YES/ often / sometimes/ rarely/ Never

Do you fear that minor complaint in another person will become a serious one? YES/ often / sometimes/ rarely/ Never

25.Ref: Red Chestnut / 4

 

26. Are you terrified? YES/ often / sometimes/ rarely/ Never

Do you have extreme fear? Do you panic easily? E.g. it is not the fear, which is limited to one human mind. It is terror. It is panic. The whole atmosphere in which one breathes appears to consist of fear with no hope of escape. Imagine the plight of passengers in a running train which has caught fire or in car running down a zigzag mountain road with failed brakes or a ship which is being bombarded from outside and has caught fire inside. Even when the condition of the patient is so serious that there is fear in the atmosphere, which affects people sitting around the patient. YES/ often / sometimes/ rarely/ Never                                                                  26.Ref: Rock Rose / 2

 

27. Are you self-disciplined? YES/ often / sometimes/ rarely/ Never

Are you very rigid? YES/ often / sometimes/ rarely/ Never

You have inflexible views which suppress the natural inner needs and prevent the personality to develop in a natural unfettered way? YES/ often / sometimes/ rarely/ Never

Do you have yourself a lot on your mind? YES/ often / sometimes/ rarely/ Never

Do you have strong opinions? YES/ often / sometimes/ rarely/ Never

Are you very strict and self-disciplined? YES/ often / sometimes/ rarely/ Never

Do you live in self-denial? YES/ often / sometimes/ rarely/ Never

Are you self-dominant? YES/ often / sometimes/ rarely/ Never

You do not usually interfere in the lives of others because you are far too concerned with your own perfection and setting an example for all to behold.YES/ often / sometimes/ rarely/ Never                                                                                       27.Ref: Rock Water / 9

 

28. Are you indecisive, uncertain, always changing, unsteady, and procrastinating and unreliable? YES/ often / sometimes/ rarely/ Never

Are you always in ‘two minds’, cannot make a decision, procrastinate decision-making, have a very uncertain mood? YES/ often / sometimes/ rarely/ Never

Are you sometimes happy and gay and the next moment sad and morose? YES/ often / sometimes/ rarely/ Never

Do you have unsteadiness in walking, in talking? YES/ often / sometimes/ rarely/ Never

When you are sick, do the symptoms change? e.g. Temperature fluctuates, pains change the place, itching now here now there, diarrohea and constipation alternate, as ravenous hunger and loss of appetite. YES/ often / sometimes/ rarely/ Never

Does your memory fail you in the examination hall,  which returns after the paper is over? YES/ often / sometimes/ rarely/ Never

Do you fluctuate between joy and sadness / energy and apathy / optimism and pessimism/ laughing and crying? YES/ often / sometimes/ rarely/ Never

Are you unreliable or uncertain due to constantly changing outlook? YES/ often / sometimes/ rarely/ Never

Do you tend to waste time and lose opportunities? YES/ often / sometimes/ rarely/ Never

Bach Flower Remedies  you feel you lack poise and balance? YES/ often / sometimes/ rarely/ Never

Are you prone to car, air or seasickness? YES/ often / sometimes/ rarely/ Never                              28.Ref: Scleranthus / 10

 

29. When a man is fighting with another man he may get injured. The injury may be simple or it may be serious, but there is no element of shock in it. His injuries can be attended to by appropriate medicines, which repair the injury. But if you are a scooterist who is waiting on the red light signal on a crossing and a fast vehicle coming from behind strikes you, or a tree falls on you when passing on a road, you are said to have been accidentally injured. Accident has an element of unforeseen–ness, which may be termed as shock. So when you are injured in an accident, you have to be treated for the shock as well as for the physical injuries. You are driving a car on a main road when a boy running from a side-lane comes before your car which is screeched to a halt inches before over-running over the boy. The boy is saved and you have no physical injury and yet you sit frozen on the seat, your heart thumping violently the mental shock. YES/ often / sometimes/ rarely/ Never

Do you have after effects of shock, physical or mental? YES/ often / sometimes/ rarely/ Never

Have you recently had an accident or sad news? YES/ often / sometimes/ rarely/ Never                                29.Ref: Star Of Bethlehem / 3

 

30. Do you feel extremely mentally tortured? YES/ often / sometimes/ rarely/ Never

Do you feel hopeless despair? YES/ often / sometimes/ rarely/ Never

Do you feel you have reached the maximum limits of your endurance, and can stand no more? YES/ often / sometimes/ rarely/ Never

Does your very soul cries in pain? YES/ often / sometimes/ rarely/ Never

Do you see no hope of redemption in the future? YES/ often / sometimes/ rarely/ Never

Do you feel pushed back to the wall-utterly helpless and unprotected, with no hope of help from any quarter? YES/ often / sometimes/ rarely/ Never

In such hopeless situations there is a very powerful flower remedy restores the mental balance and promotes positive thinking. Would you like to give the remedy a fair trial? YES/ often / sometimes/ rarely/ Never                 

30.Ref: Sweet Chestnut / 6

 

31. Are you over-enthusiastic? YES/ often / sometimes/ rarely/ Never

Are you over-busy? YES/ often / sometimes/ rarely/ Never

Do you do everything in haste? YES/ often / sometimes/ rarely/ Never

Do you goad yourself to do through your will power much more than what your physical strength would permit? YES/ often / sometimes/ rarely/ Never

If you have an idea, you not only stick to it through thick and thin, but want to propagate it amongst others? YES/ often / sometimes/ rarely/ Never

Do you over-strain yourself in impressing upon others the uniqueness and the utility of your idea? YES/ often / sometimes/ rarely/ Never

In your over-enthusiasm to do work, do you fail to give periodical rest to this human machine, which may cause complete breakdown of his physical and mental health due to constant strain and tension? YES/ often / sometimes/ rarely/ Never

Are you a perfectionist? YES/ often / sometimes/ rarely/ Never

Are you sensitive to injustice? YES/ often / sometimes/ rarely/ Never

Do you take up too many jobs at the same time? YES/ often / sometimes/ rarely/ Never                                            31 Ref: Vervain / 10

 

32. Are a very gifted and capable person with an iron will and all ingredients of making a big leader? YES/ often / sometimes/ rarely/ Never

If the answer is yes to the above question then -are all the leadership qualities in you are being used for selfish ends?

YES/ often / sometimes/ rarely/ Never

If the answer is yes to the above question, then, do you make a most ruthless dictator, devoid of love and sympathy, riding roughshod over others feelings and aspirations, etc? YES/ often / sometimes/ rarely/ Never

Are you ambitious? YES/ often / sometimes/ rarely/ Never

Are you dominating? YES/ often / sometimes/ rarely/ Never

Do you love to have power over others? YES/ often / sometimes/ rarely/ Never

Do you exercise self-righteousness? YES/ often / sometimes/ rarely/ Never

Do you never heed or care for others opinions? YES/ often / sometimes/ rarely/ Never

Are you subject to extreme tension of mind and body, resulting in painful complaints? YES/ often / sometimes/ rarely/ Never

Is your body stiff? YES/ often / sometimes/ rarely/ Never

Do you have high B.P. etc? YES/ NO

Do you expect absolute obedience from others? YES/ often / sometimes/ rarely/ Never                                            32 Ref: Vine / 12

 

33. “Old habits die hard”. Do you find yourself unable to delink yourself from your old habits? YES/ often / sometimes/ rarely/ Never

Are you over sensitive to certain ideas, atmosphere and influences? YES/ often / sometimes/ rarely/ Never

Is it very difficult for you to cut across your old way of thinking, superstitions, gambling etc? YES/ often / sometimes/ rarely/ Never

Do you want to take some major decisions-like change of profession or business, divorce, change of religion etc. but many impediments are put in your way by your elder, and your well-wishers and you are dissuaded by convincing arguments from many quarters? YES/ often / sometimes/ rarely/ Never

Is your body undergoing physical changes that is causing great discomfort or suffering? E.g. at the time of teething, puberty, pregnancy, menopause etc? YES/ often / sometimes/ rarely/ Never

Are you affected by a dominating personality, a forceful circumstance, a link with the past, a family tie? YES/ often / sometimes/ rarely/ Never

Does any situation hinder or frustrate plans or even a course of life? YES/ often / sometimes/ rarely/ Never                

33 Ref: Walnut / 7

 

34. Do you mostly like to be by yourself? YES/ often / sometimes/ rarely/ Never

Are you very capable and efficient? Are you are like pioneers and inventors who like to keep themselves away from society? YES/ often / sometimes/ rarely/ Never

Is it in your very nature to work alone? YES/ often / sometimes/ rarely/ Never

You don’t like to be disturbed when working alone, and you do not disturb others in their work. YES/ often / sometimes/ rarely/ Never

Does the specialised work, which you do without aid or advice from others sometimes induces in you a shot of superiority complex? YES/ often / sometimes/ rarely/ Never

Do you possibly suffer from physical diseases such as stiffness of joints, mental rigidity and tension? YES/ often / sometimes/ rarely/ Never                                                                                                                                                                         34 Ref: Water Violet   / 6

 

35. Do you have persistent mental thoughts, useless mental arguments, repetitive physical actions, or physical troubles? YES/ often / sometimes/ rarely/ Never

Are you imprisoned by unwanted thoughts, which persist, and which you can not get rid of despite your best efforts? YES/ often / sometimes/ rarely/ Never

Do you lack concentration and often do not answer when spoken to? YES/ often / sometimes/ rarely/ Never                                             35 Ref: White Chestnut / 3

 

36. Are you uncertain, indecisive and dissatisfied? YES/ often / sometimes/ rarely/ Never

Are you very capable and can undertake and do successfully any work, but fail to spot the right work which gives you mental satisfaction?YES/ often / sometimes/ rarely/ Never

Do you do many things and many types of jobs, earn money but you never have job satisfaction? YES/ often / sometimes/ rarely/ Never                                                      36 Ref: Wild Oat / 3

 

37. Do you have apathetic resignation with regard to inner and outer life with complete loss initiative to improve your lot? YES/ often / sometimes/ rarely/ Never     

You feel you have already lost the battle of this life and surrender to struggle of life without complaining? YES/ often / sometimes/ rarely/ Never                                                                                                                                                               37 Ref: Wild Rose / 2

 

38. Do you blame others or fate for your failure? YES/ often / sometimes/ rarely/ Never

Are you not able to stand, with grace, the success or progress of others? You are resentful and bitter if others are happy and gay? YES/ often / sometimes/ rarely/ Never

You have nothing to contribute to the world except your resentment on others success and frustration on your own failure? YES/ often / sometimes/ rarely/ Never

Do you grumble a lot? YES/ often / sometimes/ rarely/ Never                                                                                 38 Ref: Willow / 4

 

39. Are you in the near future likely to travel/ change your job/ go for an important interview/ appear for a crucial exam/ undergo a surgery/ give a public talk/ give a performance? YES/ often / sometimes/ rarely/ Never                               39 Ref: Rescue Remedy / 1               

 

Any other relevant information that you would like to provide / receive / comments –if any in the space given below….

 May All Beings be happy and peaceful.