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How to use this form
This is a list of ayurvedic healthy eating and lifestyle recommendations. For each item on the list rate your compliance with the recommendation — 1 is least compliant, 5 is most compliant. The notes in bold after each item indicates what non-compliance will aggravate. Work on low score behaviors and redo your score every 2 weeks to measure improvement.

Diet
Eat fresh food freshly prepared — ama, agni
Eat organic foods — ama
Favor whole foods—avoid refined foods — ama
Eat as low down on the food chain as possible. Lacto-vegetarian diet is preferable. Poultry and fish are better than red meats (better to have them at lunch than supper). — ama
Use mainly olive oil (low heat) and ghee for cooking oils — K, ama, agni
Drink 3-4 glasses of room temperature or warm water throughout the day — ama
Avoid packaged and processed foods — ama
Avoid leftovers — very ama producing, K
Avoid cold foods and beverages — K, ama, agni
Avoid cooking oils at high heat — ama
Avoid cooking with aluminum pans — ama
Avoid eating at restaurants more than twice a week unless food meets Ayurveda standards — ama
Avoid caffeine beverages like coffee and soft drinks — V, P
Avoid carbonated beverages — V
My Diet Plan for now is V, P, K
How successful am I in following the guidelines on this diet Plan? — general imbalance
My dietary spice plan is V, P, K
How successful have I been in using these spices? — ama, agni

Digestion and Eating Behavior
Regular mealtimes, around the same time each day: breakfast, lunch, supper and (optional) afternoon snack. — V, ama, agni
Have a lighter breakfast ideally with some clove spice to enliven digestion by lunch — K, ama, agni
Make lunch the largest and main meal of the day — ama, agni
Eat lighter in the evening — K, ama *absolutely crucial for weight loss
Eat before 7 PM in the evening — K, ama
Do not snack after 10 PM in the evening — P, K, ama
Do not eat right before going to bed. Warm, boiled milk is all right. — K, ama
Eat in a quiet, settled atmosphere with settled mind — V, agni
Chew food well—digestion begins in the mouth — ama, agni
Take a few minutes to sit quietly after eating — V, ama, agni
Eat only when hungry. — ama, agni
Avoid eating before the previous meal is digested (3 to 6 hours between meals) — ama, agni
Avoid large amounts of raw food, such as raw vegetables. Naturally grown, ripened fruits are fine. — V
Avoid food that has honey cooked in it — ama
Avoid using the microwave — V, ama
Avoid skipping meals and going hungry for long periods — P, agni
Only drink milk with grains or foods having the sweet taste and AVOID taking milk with raw fruits, vegetables, meat, fish, sour food and eggs? — ama
Respect the principle of acquired suitability (Oka-satmya) —

Bowel Function
Adequate fiber — ama
Adequate oils: olive oil / ghee (if no cholesterol problem) — ama
Adequate fluid intake — ama
Adequate exercise, yoga — ama, agni
Probiotics: lassi, yogurt, kefir — ama
Herbal preparation: Triphala 1-2 grams at bedtime — ama
Upon arising, drink 1-2 glasses of lukewarm water — ama
Give it time, every day in the early morning — ama
Avoid suppressing natural urges like bowel movements and urination — V, ama

Sleep
Early bedtime: lights out by 10 PM — V
Wind down for at least an hour before bed (2 hours is better): no TV or screens (avoid “blue light”) — V
Use natural fabric bedding and clothes for sleep — V
Take an evening walk in Kapha time (6-10 PM) and go to bed afterwards without watching TV or reading — V *very helpful for sleep
Do not have an office or work in my bedroom or be on the computer and watch TV — V

Lifestyle Balance
Regular awakening – Arise before 6 AM — K
Regular bowel movements, morning preferred — ama
Clean tongue in the morning — ama
Regular morning abhyanga — V, ama
Regular morning asanas — ama
Regular morning pranayama — K
Regular morning meditation — *crucial for overall balance
Regular morning walk or exercise — K, ama
Regular evening meditation — *crucial for overall balance
Follow hot water drinking recommendation — ama *crucial for overall balance
Wear natural fabric clothing — V
Avoid night shifts if possible — V

Vastu Orientation to Environment
Meditate facing East
Top of head pointed East when sleeping. Avoid top of head facing North when sleeping.
Using East or North as main entrance to the house
Office desk faces East or North

Women Only
Increasing rest during period and ideally not working for 2-3 days — *considered highly important for female health and happiness