AYURVEDIC and HERBALIST WELLNESS CONSULTATION AGREEMENT AND WAIVER CONSULTATION TYPE(Required) AYURVEDIC CONSULTATION:* HERBALIST CONSULTATION:* AYURVEDIC & HERBALIST CONSULTATION:* AYURVEDIC CONSULTATION:*Consent(Required) I understand and agree that this wellness consultation will be based on the principles of Ayurveda, an alternative approach to health, and that this consultation or any information I may gain are different from, and not a substitute for modern medical evaluation and treatment or preventative testing. (Tests including but not limited to: Blood test, Pap smears, colon screening, mammograms.)Consent(Required) I understand that Ayurveda uses a unique system with a valuation and health based on the concept of balance of three doshas, balance of elements and qualities and overall tissue health. I understand that the consultation’s purpose will be to assess the level of balance in the physiology and to make recommendations based on the Ayurveda health approach to health and support the inner intelligence of the body and restore balance to the physiology.HERBALIST CONSULTATION:*Consent(Required) I understand and agree that this wellness consultation will be based on the principles of Herbology, an alternative approach to health, and that this consultation or any information I may gain are different from, and not a substitute for modern medical evaluation and treatment or preventative testing. (Tests including but not limited to: Blood test, Pap smears, colon screening,Consent(Required) I understand that Herbology uses a unique system with a valuation and health. I understand that the consultation’s purpose will be to assess the level of balance in the physiology and to make recommendations based on the Herbalist approach to health and to support the inner intelligence of the body and restore balance to the physiology.AYURVEDIC & HERBALIST CONSULTATION:*Consent(Required) I understand this consultation and recommendations. I will receive are not for the purpose of diagnosing or treating any disease that I may have.Consent(Required) I understand the pulse evaluation is for the purpose of assessing overall balance and is NOT for diagnosing the presence or absence of any particular disease.Consent(Required) I agree to consult with my family physician regarding all the matters pertaining to any prescription medication or modern medical treatment I may be taking.Consent(Required) I recognize and agree that any device or recommendations to me as the sole responsibility of the educator and no other person or organization.This field is hidden when viewing the formSection Break*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. The information on this website is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. For more information pertaining to your personal needs please see a qualified health practitioner. “I am a Registered Herbalist (AHG), not a licensed medical professional. The information provided in my consultations is intended to support your overall health and wellness and is not intended to replace medical advice or treatment. It is important to work with your primary healthcare provider and to inform them of any herbs or supplements you are taking. Herbs may have side effects, cause individual sensitivities, or interact with medications, and it is important to discuss these risks with your healthcare provider.”Name(Required) First Last Signature(Required)CommentsThis field is for validation purposes and should be left unchanged. 81148