Ayurvedic Health Assessment Form
For all new and prospective clients
Click here: Complete Health Assessment Form
This comprehensive health assessment form allows Khabir to prepare for and review your case in detail before your appointment. This process saves time and leads to a more comprehensive diagnosis.
After you complete this form schedule your appointment
OR call Khabir @ 805-858-9222 to discuss your case. (If you cannot complete this form on-line, it can be mailed to you or completed in the clinic before your appointment.)
Forms need to be completed on a computer or Ipad not a cell phone.
Note: You will need to sign and submit the form at the end. The form is not printable.
Returning Patient Forms
- Returning patient assessment form: Tissues & System Assessment Form - Helpful (but not required) for returning patients after 6 months or more.
- Daily Journal for existing patients: Daily diet & Lifestyle Journal - For active patients seeking dietary feedback.
To discuss your case after completing a form call or text Khabir at: 1-805-308-3480
Days & Times
The clinic is available for last minute appointments, however, an appointment is still required. Appointments are generally scheduled Monday through Thursday between 10:00am to 5:00pm and half day Saturday with availability on weekends and evenings upon request.
Many families find they share the same health challenges and/or wish to implement lifestyle changes as a family instead of restricting healthy changes to a single member of the family. I am happy to consult with families and couples together. Bring your partner or family member to support you!
Payment for services is required at the time of appointment for office clients or in advance for remote clients (i.e. Skype, email, Google Hangout, phone). Detailed receipts will be provided by email for all services and products purchased.
Visa, MasterCard and Amex are accepted. PayPal is also accepted. Checks should be payable to Natural Healing Consultants.
Appointments missed or cancelled in less than 24 hours will incur a $50 charge. Exceptions to this policy may be made for emergency situations on a case-by-case basis.
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, $15 for a 2 oz jar; $25 for a 4 oz jar; and $35 for a 6 oz glass jar of powdered herbs; $15 or $20 for a 2.5 oz or 3.0 oz bag of loose herbal tea blends; and $15 for 4 oz of herbal oils. Prices are sometimes adjusted based on the cost of the ingredients not the weight. (Herbal products may be shipped in plastic bags instead of glass jars.)
We do not bill insurance directly, but we will prepare a detailed bill which you can submit to your insurance company for reimbursement, if your insurance covers naturopathic or nutritional therapy visits. We do not bill Medicare.