Christopher Hedley: Humours, Sheet 1.

Copyright © 2003–2019 Christopher Hedley.

Record sheet - first page

Please complete and return at the end of your trial.

All Information will be treated as confidential.

Name ____________________ ____________________
Date ____________________ ____________________
Age ____________________ ____________________
Sex ____________________ ____________________
Occupation(s) ____________________ ____________________ ____________________

Number of ticks for each humour:

Choleric (fire) _____
Phlegmatic (water) _____
Sanguine (air) _____
Melancholic (earth) _____

Your assessment of your humoral balance (in a sentence): ____________________ ____________________ ____________________ ____________________ ____________________

Regime

Recommendations for Diet, Exercise & Lifestyle that you feel you can follow. Fill in both what you have decided to AVOID and what you decide to TAKE/DO.

Diet ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________

Exercise ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________

Lifestyle ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________

Herbal teas
Decide on one or two herbal teas, mixed or simple, which you aim to take daily. Note these below: ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________

Audit

Assess the following, on a scale of 1 - 7 (1 for the worst possible, 7 for the best)

ENERGY LEVELS (physical energy, how much you can do, how much you get done) ___

MENTAL ENERGY (focus, concentration, clarity, ability to think things through) ___

WELL BEING (mood, how you feel about yourself, emotional state) ___

QUALITY of SLEEP ___

QUALITY of DIGESTION (all aspects) ___

OVERALL STATE of HEALTH ___

Describe the colour and texture of your Urine ____________________ ____________________

The second page is overleaf. PLEASE FILL IN WITHOUT REFERENCE TO THE ABOVE.