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Clinic Forms

Khabir's Online Clinic Forms

For all new and prospective clients

Form Used for
Complete Health Assessment Form 
(for Texans see link to form below)
Comprehensive intake for new clients so Khabir can evaluate your health from a traditional Ayurvedic perspective and understand your history.
Existing Client Form — Follow-up For returning clients with new health concerns, or those returning after two years or more.
Nutritional Deficiency Assessment Questionnaire For new or existing clients planning a Nutritional Deficiency Assessment & Supplement Recommendations appointment.
New Client Form for Product Guidelines For clients with an appointment to receive guidance on products previously purchased on HerbManTeas.com.
Complete Health Assessment Form (for Texas Clients)  Comprehensive intake for new clients (in Texas) so Khabir can evaluate your health from a traditional Ayurvedic perspective and understand your history.
Formulario de Evaluación de Salud (Español) Formulario de Evaluacion Ayurvédica del cliente en Espanol

The forms can be completed on a cell phone or computer and can be saved to continue later.

If you haven't already done so, please schedule your appointment online.

Schedule Now

Or call 888-611-0878 for assistance.

To discuss your case with Khabir after completing a form call or text:
888-611-0878

You can schedule a FREE 30-minute appointment or an appointment on Zoom.

Fees


Clinic Details

Days & Times

The online clinic is available for last-minute appointments; an appointment is still required. Appointments are generally scheduled Monday–Thursday between 10:00 a.m. and 5:00 p.m., and half-day Saturdays, with availability on weekends and evenings upon request.

Family Consultations

Many families share similar health challenges or prefer to implement changes together. I’m happy to consult with families and couples. Bring your partner or a family member to support you!

Payment Policy

Payment is required at the time of appointment (office) or in advance for remote (Zoom) clients. Detailed receipts will be provided for all services and products purchased. Accepted Cards

Visa, MasterCard, and Amex are accepted. PayPal is also accepted. Checks should be payable to Natural Healing Consultants.

Cancellation Policy

Appointments missed or cancelled with less than 24 hours’ notice will incur a $50 charge. Exceptions may be made for emergencies.

Products

Teas, herbal formulas, supplements, spices, oils, and other products are not included in consulting fees unless stated. We use the highest quality, ethically wildcrafted, pure, and organic herbs. Herbal product costs: Generally, $17.50–$22 for loose tea blends (2.5–3.0 oz), $27–$38 for 4–6 oz powdered herbs, and $17 for 4 oz herbal oils. Prices may vary based on ingredient costs. (Products may be shipped in bags instead of jars.)

Insurance

We do not bill insurance directly; we will prepare a detailed bill you can submit for reimbursement if your plan covers naturopathic or nutritional therapy visits. We do not bill Medicare.


* Privacy

We do not sell, trade, or otherwise transfer your personally identifiable information. Your data is behind secured networks and only accessible to authorized personnel who are required to keep it confidential. See the complete privacy policy.

* Security

All transactions are processed through a gateway provider and are not stored on our servers. Forms are hosted securely by Cognitoforms.com (bank-grade security and proprietary encryption).

Schedule a Consultation


 

Completed Form

Schedule & Appointment Information

How to book, what to expect, and helpful policies

Schedule Online

If you haven't already done so, please schedule your appointment online.

Schedule Now

OR call 888-611-0878 for assistance.


Discuss Your Case

To discuss your case with Khabir after completing a form call or text:
888-611-0878


Availability

The online schedule will only allow bookings on Zoom on the days and times Khabir is available. See his schedule and availability.

Work Days & Times

Appointments are generally scheduled as follows:

Monday through Friday

  • Pacific Time (PT): 9:00 a.m. – 4:00 p.m.

  • Mountain Time (MT): 10:00 a.m. – 5:00 p.m. (during DST)

  • Central Time (CT): 11:00 a.m. – 6:00 p.m. (during DST)

  • Eastern Time (ET): 12:00 p.m. – 7:00 p.m. (during DST)

Saturday (half day)

  • Central Time (CT): 11:00 a.m. – 1:00 p.m.

  • Pacific Time (PT): 9:00 a.m. – 11:00 a.m.

  • Mountain Time (MT): 10:00 a.m. – 12:00 p.m.

  • Eastern Time (ET): 12:00 p.m. – 2:00 p.m.

Ayurvedic Health Assessment Form

For all new and prospective clients 

Click here:  Complete Ayurvedic Health Assessment Form 

This comprehensive health assessment form enables Khabir to thoroughly prepare for and review your case in detail before your appointment.  This process saves time and leads to a more thorough understanding of your individual wellness needs from a traditional Ayurvedic perspective.

After completing this form, please schedule your appointment. 

Your information remains completely confidential and private.*

 
Personal Checks, Visa, MasterCard, Amex, and PayPal are also accepted.  

To discuss your case after completing a form call or text Khabir at: 1-888-611-0878


 Work days and times

 Appointments are generally scheduled Monday through Friday between 9:00 a.m. and 4:00 p.m., and half-day Saturdays, with availability on weekends and evenings upon request.

Remote Appointment

Khabir uses only Zoom.   Khabir will send the Zoom link when he is ready, not days or hours before.   Sometimes he is behind schedule, so please don't worry. If you are concerned, contact customer support by email or text at 888-611-0878 

Family Consultations

Many families find that they share the same health challenges and/or wish to implement lifestyle changes as a family, rather than restricting healthy modifications to a single member. I am happy to consult with families and couples together. Bring your partner or family member to support you!

Payment Policy

Payment for services is required at the time of appointment for office clients or in advance for remote clients on Zoom.  Detailed receipts will be emailed for all services and products purchased.

Visa, MasterCard, and Amex are accepted. PayPal is also accepted. Checks should be payable to Khabir Southwick.

Cancellation Policy

There is no charge for canceling your appointment.  However, the sooner we know, the better.

Product Recommendations 

Teas, herbal formulas, supplements, spices, oils, and other products are not included in consulting fees or programs unless specifically stated.  We use the highest quality, ethically wildcrafted, pure, and organic herbs in our herbal preparations. * Herbal product costs: Generally, $18 to $20 for a bag of cut and sifted tea; $29 to $39 for a bag of powdered herbs; and $15 for 4 oz of herbal oils. Prices are sometimes adjusted based on the cost of the ingredients, not the weight.

Insurance

We do not bill insurance directly, but we will prepare a detailed bill that you can submit to your insurance company for reimbursement if your insurance covers naturopathic or nutritional therapy visits.  We do not bill Medicare.

Privacy

We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information.   Your personal information is stored within secure networks and is accessible only to a limited number of individuals who have been granted special access rights and are required to maintain confidentiality—the complete privacy policy.

* Security

All transactions are processed through a gateway provider and are not stored or processed on our servers. Forms (available via the links above) are securely managed online by Cognitoforms.com.  (Cognito Forms utilizes bank-grade security and proprietary encryption techniques to ensure the highest level of protection for your documents and data.)

Consent & Disclaimer Summary

By booking a consultation, purchasing products, or using this website, I acknowledge that Brad Southwick (Southwick Health Ranch) is not a licensed healthcare provider. Services and products are offered solely for educational and traditional wellness purposes. They are not intended to diagnose, treat, cure, or prevent any disease, nor are they a substitute for licensed medical care. I understand it is my responsibility to consult a qualified healthcare provider for any medical concerns and accept full responsibility for how I use any information or products provided.


         

Khabir Southwick is available for consultations remotely via Zoom, offering his expertise to clients worldwide.

 Fees and Health Assessment Forms

Call or text 888-611-0878 for more information.  For general inquires: email support @ KhabirsClinic .com

Disclaimer:

Disclaimer: Khabir’s Health Consulting, LLC (WY), DBA Khabir’s Clinic, provides non-medical, educational services rooted in traditional natural health systems such as herbalism, nutrition, and Ayurveda. Khabir Southwick is not a licensed physician, and no diagnosis, treatment, or cure is offered or implied. All services and recommendations are strictly informational and educational in nature. Clients are responsible for their own health decisions and are encouraged to consult a licensed medical provider for any health concerns.

 Complete Disclaimer.  Privacy Policy

© 2009-2023 Khabir Southwick