Khabir's Online Clinic Forms
For all new and prospective clients
| Form | Used for |
|---|---|
| Complete Health Assessment Form | 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. |
| 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.
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.
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. 
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).
