• DORIKA MAHO®️ -NATURAL WELLNESS YOU DESERVE •
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DM CHIKARA
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Contact Us
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Shop
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DORIKA MAHO
DM CHIKARA
DM MAMORU
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1. Do you experience sudden fever OR coughing OR common cold in the past 3 months?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
2. Do you experience headache in the past 3 months?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
3. Do you experience acne/ eczema/ inflamed/ itchy/ dry OR sensitive skin in the past 3 months?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
4. Do you experience muscle OR joint pain in the past 3 months?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
5. Do you experience difficult/ passage of hard stools OR frequent painful bowel movements OR infrequent passage of stools (less than 3 times a week)?
A: Regularly (3 points)
B: Occasionally (2 points)
C: No (0 point)
6. Do you experience the feeling of an incomplete bowel movement?
A:Regularly (3 points)
B: Occasionally (2 points)
C: No (0 point)
7. Do you experience any discomfort OR pain in the abdomen?
A: Regularly (3 points)
B: Occasionally (2 points)
C: No (0 point)
8. Do you experience lost of appetite/bloating OR feel sick frequently?
A: Regularly (3 points)
B: Occasionally (2 points)
C: No (0 point)
9. What is the shape of your stool?
A: Constipation (3 points)
B: Normal (0 point)
C: Diarrhea (2 points)
10. Do you experience pain OR discomfort in/around your eyes? (e.g. burning, itching, aching, drying)
A: Regularly (3 points)
B: Occasionally (2 points)
C: No (0 point)
11. How many hours you use your eyesight over devices with screen or light source?
A:> 4 hours (3 points)
B: 2-4 hours (2 points)
C: < 2 hours (0 point)
12. Do you experience slow wound healing?
A: Regularly (3 points)
B: Occasionally (1 point)
C: No (0 point)
13. Do you experience bleeding gum OR ulcer?
A: Regularly (3 points)
B: Occasionally (1 point)
C: No (0 point)
14. Do you go to sleep easily and sleep (7-8 hours) through the night everyday?
A: Yes (0 point)
B: Occasionally (2 points)
C: No (4 points)
15. Do you get at least 30 minutes of exercise OR activity everyday?
A: Yes (0 point)
B: Occasionally (2 points)
C: No (4 points)
16. Do you eat balanced diet every meal?
A: Yes (0 point)
B: Occasionally (2 points)
C: No (4 points)
17. Do you OR parents/ family members have any chronic illness or diseases?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
18. Are you a smoker/ drinker?
A: Yes (4 points)
B: Occasionally (2 points)
C: No (0 point)
19. How would you describe your working mood?
A: Stressed and tired (4 points)
B: Manageable (1 point)
C: Quite leisurely (0 point)
Total Points :
Points
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