Before beginning the SAF 120 Questionnaire, please have a complaint in mind, something you would like to work on, a present day distress. It can be an emotion, a situation or a symptom ("I have trouble with ----"). Please make a note of the complaint.  

With your complaint in mind, answer the questions according to intensity:
0 - Never 1 - Rarely 2 - Occasionally 3 - Regularly 4 - Often 5 - Very Often

1. Are you prone to infection?
2. Do you have inflammation?
3. Do you have specific pains?
4. Do you have swellings?
5. Do you have pus or mucus formations?
1. Do you have pains in your chest?
2. Do you have constrictions in your chest?
3. Do you have blood clots?
4. Do you have heart palpitations?
5. Is your pulse strong (do you feel pounding in your temples)?
1. Do you have diarrhea?
2. Do you have colitis?
3. Do you notice intestinal mucus in your bowel movements?
4. Do you use laxatives?
5. Do you feel weak after bowel movements?
1. Do you have acid indigestion?
2. Do you have gas (belching, flatulence)?
3. Do you have heartburn (bad taste in the mouth)?
4. Do you have ulcers?
5. Is your abdomen bloated?
1. Do you have the flu?
2. Do you have pain in your limbs?
3. Is there mucus in your nasal passages?
4. Does your chest feel oppressed?
5. Do your limbs feel rigid?
1. Do you have gallstones?
2. Do you feel tired after eating?
3. Are you jaundiced (dark yellow skin or urine)?
4. Do you feel constant hunger?
5. Do you feel irritated (constantly complain)?
1. Do you have a cough?
2. Are you hoarse?
3. Do you have hay fever?
4. Do you feel as if you are choking?
5. Do you have suffocation attacks?
1. Do you get flushes of heat?
2. Do you have cold perspiration?
3. Do your genitals itch?
4. Do you have irregular menstruation?
5. Are you physically weak?
1. Do you have low back pain?
2. Is your back sprained?
3. Do you have chronic soreness in the low back?
4. Do temperature changes affect your condition?
5. Do you have a stiff neck and/or shoulders?
SAF 120 GROUP 10
1. Do you have difficulty walking?
2. Are you forgetful?
3. Do you have vertigo (dizziness)?
4. Do you have a tendency toward fearfulness/anxiety?
5. Do you feel like you can't take the heat?
SAF 120 GROUP 11
1. Do you have varicose veins?
2. Do you have hemorrhoids?
3. Do you have anal fissures?
4. Do you have itchy piles?
5. Do you have bleeding piles?
SAF 120 GROUP 12
1. Do you have insomnia?
2. Are you nervous?
3. Do you have mental conflicts of long duration?
4. Are you a light sleeper?
5. Do you feel drowsy in the morning from not having enough sleep?
SAF 120 GROUP 13
1. Are you exhausted?
2. Do you feel like you can not concentrate?
3. Are you worried?
4. Do you feel like energy is slowly draining from your body?
5. Do you dislike talking about your condition?
SAF 120 GROUP 14
1. Do you have neuralgia (nervous pain)?
2. Do you get migraine headaches?
3. Do you have earaches?
4. Is your head congested?
5. Do you sense that something bad is going to happen?
SAF 120 GROUP 15
1. Do you feel like you need more energy?
2. Do you feel as though you are "getting old"?
3. Do you feel worn out?
4. Are you sensitive to sun, heat, and other forms of radiation?
5. Do you have warts, moles, ulceration and other skin disorders?
SAF 120 GROUP 16
1. Do you get sharp stinging pain in the low back?
2. Do you have pains that pierce the bladder?
3. Is your bladder weak?
4. Do you have pain when urinating?
5. Are you nauseous?
SAF 120 GROUP 17/18
1. Do you feel chilly?
2. Do you have high blood pressure?
3. Does it hurt to think?
4. Do you have a bad memory?
5. Do you have to get up to go to the bathroom in the middle of the night?
6. Do you have allergies?
7. Do you have hypoglycemia?
8. Do you have diabetes?
9. Is your digestion poor?
10. Do you have sexual disturbances (impotence, frigidity, etc.)?
SAF 120 GROUP 19
1. Do you have rashes, acne, warts or cysts?
2. Does your skin itch?
3. Do you have eruptions around your fingernails?
4. Do you have scabs around your ears?
5. Do you tremble all over?
SAF 120 GROUP 20
1. Are you under a lot of stress?
2. Do you feel that you have low stamina?
3. Do you feel that you have some hidden condition?
4. Do you catch cold easily?
5. Do you have swollen glands?
SAF 120 GROUP 21
1. Do you have strong body odor?
2. Do you perspire excessively?
3. Is your sweat sticky?
4. Do you feel nervous tension after minimal physical activity?
5. Do your palms sweat?
SAF 120 GROUP 22
1. Do you have fragile bones?
2. Do you have cataracts?
3. Do you have convulsions?
4. Do you have arthritis?
5. Are your bones and teeth decayed?
SAF 120 GROUP 23
1. Do you have asthma?
2. Do you feel as though you need to inhale fresh air?
3. Have you had a shock, trauma or injury?
4. Do you have bronchitis?
5. Is your breathing irregular?
SAF 120 GROUP 24
1. Are you addicted to drugs (especially narcotics)?
2. Do you drink alcohol?
3. Do you smoke or chew tobacco?
4. Do you feel that you are emotionally unstable?
5. Are you easily prone to sighing and sobbing?

At the end of the Questionnaire, you'll see your SAF® chain of numbers. Please enter your email or client key, if you have one, to have a summary of your results sent to you and your practitioner. The SAF® Questionnaires are an integral part of the Self Awareness Formulas of Joseph R. Scogna, Jr. Copyright © 1980-2018 by Kathy M. Scogna. All Rights Reserved. SAF® is a registered trademark.