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Ayurvedic Intake Form
Your answers to these questions remain 100% confidential. Thank you for trusting me as a support person in your life. I'm really honored and excited to start working with you.
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Email
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Your email
Name
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What is your primary concern or area of interest in regards to Ayurveda?
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Do you have any aches, pains, or injuries that affect your daily routine or mood?
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Are you currently taking any prescription or over the counter medications? If so, can you please list them here?
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Are you currently taking any supplements or herbal medicine? If so, can you please list them here?
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What's one thing you would LOVE to get out of our time together?
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Is there anything else you'd like me to know before we meet?
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