Ayurvedic Wellness Counselor Case Study Presentation Format Name:
The current health concerns: 1. 2. 3. 4. 5. Initials______________ Dates___________________________ Age________________ Gender__________________________ The current health concerns: 1. 2. 3. 4. 5.
Relevant Health History:
Dietary and Lifestyle Status:
Assessment/Observations:
Conclusion of Assessment: Prakriti/Constitution: Agni/Ama: Dosha/Subdosha aggravated: Dhatu/Mala affected:
Suggestions: Inputs: Lifestyle: Suggested Herbs/Spices: Food Water Breath Perception Lifestyle: Sleep Activity Daily regiment Work Mind care Suggested Herbs/Spices: