1. Ayurvedic Wellness Practitioner Case Study Presentation Format
Name:

2. The current health concerns: 1. 2. 3. 4. 5.
Initials______________ Dates___________________________
Age________________ Gender__________________________
The current health concerns: 1. 2. 3. 4. 5.

3. Relevant Health History:

4. Dietary and Lifestyle Status:

5. Assessment/Observations:

6. Conclusion of Assessment:
Prakriti:
Agni/Ama:
Dosha/Subdosha aggravated:
Srotas affected:
Current expression:

7. Suggestions: Inputs Lifestyle Herbs/Formulations Yoga/Pranayama
Ayurvedic Techniques