Pyramid-Vastu Questionnaire Evaluation

For living or work Place

www.pyrahealth.com

Name: __________________________

Address: ________________________

City: ___________________________

State: __________________________

Zip: ____________________________

Phone: _________________________

Cell: ___________________________

Email: __________________________

Fax: ___________________________

Please print or write clearly.

This information will be used solely for Pyrahealth Product Evaluation.

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Is this a rental, lot, home and/or business?

What is the shape of each of the rooms, square, rectangular, or irregular?

Please draw on a separate sheet of paper/s and indicate the directions (North, East, South, West, North East, North West, South East, South West),
and measurements of each side of the lot and dwelling.

Draw out a floor plan of house indicating direction and measurement of each room. Create a separate
page for each level. Include all areas:  Closets, laundry room, bathrooms (full bath, half, or toilet and sink only, family room, garage, etc.  Include directions.

Indicate exactly where are the water heaters, boilers, propane tank, electric meter, large rocks, shrubs, refrigerator, stove, sink, water body, stairs, hill/s, stream or other energy forms.

Is there a slope (downward decline of land more than 6"), and in what direction?  Particularly observe if there is a slope in South or West.

What directions, if any, does your roof slope?

Clearly indicate the placement and directions of the main door and all entrances.

Is there any church, temple, cemetery, large building, high rise, or other noticeable structure near
the area/dwelling?  What?  How far from your property?

Other significant information:

You may send information by fax or mail to:

Pyrahealth Products
4905 W. 84th Street,
Bloomington Minnesota 55437

Tel:1-877-453-3640
Fax: 952-400-8008
Attn:  Swami or Priya