Travel Consultation Case Sheet

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Travel Consultation Case Sheet

  1. 1. 02 9904 7754 • 17 Orchard Road Chatswood Sydney 2067 www.ayurvedaelements.com • info@ayurvedaelemnets.com ABN 17-335-545-355 Personalised Ayurvedic Health Program for ………………………………………… …………2008 by Ayurvedic Doctor Rama Prasad Bachelor of Ayurvedic Medicine & Surgery. Enquire about   1 year Ayurveda Certificate Training  Rejuvenation Tour  Health Resorts  a;yur;roGys;w:ymè wishing you long, healthy, fulfilled life
  2. 2. What is your constitution? Elements In Universe and Life Attributes and geometrical shapes of elements are permanent. It is important to understanding the ‘type’ and engaging it wisely. Ether Air Fire Water Earth Wisdom Mobility Transformation Attraction Integrity Bliss, stillness Rhythm Heat Fluidity Stability Tranquility Cycles Intensity Bond Solidity Calmness Lightness Precision Flexibility Gravity My Permanent Body Constitution What’s the shape of your body when you are/were healthy? Ether Air Fire Water Earth Tall Small Angular Soft Solid Delicate Short Triangular Rounded Rectangular Slender Light Muscular Curvaceous Heavy bones Ayurveda Elements Courses & Consultation in Sydney, Canberra and Melbourne Phone/fax: 02 9904 7754 17 Orchard Rd Chatswood Sydney 2067 info@ayurvedaelements.com www.ayurvedaelements.com My current Physical Excess imbalance can occur to any body type. use or abuse of “elements of life”. Any Most imbalances are due to overuse, under Ether Air Fire Water Earth Depletion Irregular Over heated Sluggish Rigidity Loss Improper, twists Acidity Mucusy Clot Thinning Aches, pain Redness Weight gain Growth Waning Dehydrated Burning Excess fluid Spur My current Psychological Excess Ether Air Fire Water Earth Absence Fluctuating, shifty Irritable Clingy Stubbornness Loss Mental blockage Easily angered Sluggish Inflexibility Irrational Confusion, worry Easily impatient Greedy Overpowering Anxiety Insecurity, fear Frustration Procrastination Rigidity
  3. 3. My Constitutional Abilities Ether Air Fire Water Earth Creative Adaptable Analytic Listener Structured Meditator Multitasking Driven Carer Methodical Open Easy going Challenging Gentle Hands on Charitable Communicator Competitive Tolerant Routine lover Philosopher Dancer Result oriented Nurturer Supervisor Scientist Teacher Precise Parental Administrator Thinker Musician Sharp, intense Chef Manager Dreamer Performer Marketer Nurse Coach/ Trainer My permanent body type is …………… …………… element predominant My current work is …………… …………… element predominant My current lifestyle is …………… …………… element predominant My current relationship is …………… …………… element predominant Changes I need to make …………… …………… …………………… ……………………………………………… …………… …………………… Elements and life Categories Ether Air Fire Water Earth Exercise Meditation Aligning Cardio Stretch Toning Awareness Breathing Sprinting Yoga (asana) Weights Nutrition Philosophy Fiber Digestives Carbs, fats Protein Fasting Freshness Metabolic Essential fats Minerals Room Spacious, Everything, Efficiently organised Convenient, Brick walls, uncluttered everywhere accessible timber floors Tools, Minimal All shapes, sizes, Most efficient, Comfort items, food, Lasting, reliable, furniture variety fastest, latest cushions strong Vacation Meditation retreat Surprise me, Competitive, Water side, food, Physical, getting unpredictable challenging friends, cushions hands dirty Silent, wilderness Something totally Mountain biking, Pampering, yoga Outback, gardening, outrageous white water rafting retreat renovation Olympic High jumpers Marathoners Sprinters Gymnasts Weight lifters
  4. 4. Ayurvedic Tongue Analysis | Ayurveda Elements | 02 9904 7754 Name ……………………………………… Date ………………… Location …………………………… …………………………………………… ……………………………………………………………………………………………………… …………………………………………… ……………………………………………………………………………………………………… …………………………………………… ……………………………………………………………………………………………………… …………………………………………… ……………………………………………………………………………………………………… …………………………………………… ……………………………………………………………………………………………………… …………………………………………… ……………………………………………………………………………………………………… Copyrighted to Ayurveda Elements 2005
  5. 5. Phone/fax 02 9904 7754 Web: www.ayurvedaelements.com Email: info@ayurvedaelemnets.com 17 Orchard Road Chatswood Sydney 2067 ABN 17-335-545-355 Personalised Program for ………………………………………………………………………………………………………… ……………………………… tablets at least half hour before breakfast and dinner or at 6 am and 5 pm. ……………………………… tablets at least half hour before breakfast and dinner or at 6 am and 5 pm. Advice 1 ……………………………… powder after breakfast, lunch and dinner, along with 50 ml water. Breakfast, lunch and two snacks are good for the time being. The last snack can be slightly larger and can be taken at around 6 pm. Chew everything at least for 25 times. Advice 2 Sip water. Don’t gulp it down. No solid meals after 6 pm. Food and drinks should be warm. Avoid hot spices and oils; fermented and refined; additives and colours in food during this 6 weeks. Therapies 20 minute self massage with sesame oil before taking a warm bath 2-3 times weekly. Cleanse Walk for 20 minutes daily, with long stride and deep breathing. Exercise Low impact cardio, for 30 minutes to sweat. Yoga asana Continue. Meditation Daily at bedtime / morning / after work. Light Alkaline shopping list. Information given Gall bladder cleanse. Sinus cleanse. Important: 1. It is a possibility that the client may go through a ‘healing crisis’ during some treatments though rarely. Symptoms and signs can vary from simple flus and colds to diarrhoeas, constipation, bloating, headaches, rashes, dizziness etc. They will go away with adequate care. In this case please email Rama immediately. 2. If you need any further short explanations or clarification please email Rama. His office will contact you as soon as possible. Dr. Rama Prasad B.A.M.S.
  6. 6. Phone/fax 612 9904 7754 17 Orchard Road Chatswood Sydney 2067 Email: info@ayurvedaelements.com Web: www.ayurvedaelements.com ABN 17-335-545-355 Tax Receipt Name Date Receipt number D D D Service Category Fee/charge Subtotal Consultation (Herbal / Natural Therapy / Ayurveda) Fee Tablets .00 .00 $………00 .00 .00 Practitioner only medicines .00 .00 .00 Rama Prasad, Ayurvedic Physician, Natural Therapist and Herbalist. Health Funds and Provider Numbers ATMS 9364 Australian country health 21011871 HCF A160029 Australian Health management 21011871 Illawarra Health Fund 21011871 CBHS 9364 Manchester Unity 9364 Government Employees 21011871 Mutual Health 21011871 Grand United 01079930 AHM (Australian Health management) 21022412 Ask your health fund about Ayurveda. Have you ever Bathed an elephant? South India Tour 2009 • 14 days - beachside, mountaintop and backwater rejuvenation • Indulge in healthy and yummy traditional cuisine • Enjoy houseboats, palaces, temple and much more • Night trekking, bamboo rafting, spice plantation visits • Ride and bathe an elephant and many more activities…   For prices and exact dates, please call 02 9904 7754 or log on  to our website. Your guide, Rama Prasad is an Ayurveda doctor  and Kerala local.
  7. 7. My current health status After being on the ayurvedic program for a month is as follows. Fill in the blanks if applicable. 1. The easiest part of the program is 2. The most difficult part of the program is 3. The most satisfying part of the program is 4. I need more clarifications on 5. I couldn’t do this 6. I followed the new nutrition program about ……% perfectly 7. I followed the new cleansing about ……% regularly 8. I followed the new practices about ……% perfectly 9. My exercise was ……% regular/perfect 10. I took the medicines about ……% regularity 11. The amount of medicines yet to be finished is ……% in quantity 12. Overall I followed the advise about ……% perfectly 13. My energy feels better by ……% 14. Being on the program, I wake up refreshed by ……% 15. Being on the program, my mental clarity is better by ……% 16. Overall I am better by ……% 17. I feel definite the improvement in the following area 18. The problems still to be improved is/are 19. New problems are
  8. 8. Alkaline Antioxidant Shopping List Name …………………… Date ……………Duration … month Some basic rules: REGULAR USE FRUITS BEANS HERBS SPICES TEAS STOP/REDUCE NUTS & SEEDS Apples Adzuki beans Allspice Alfalfa Almonds –soaked Drink your solids VEGETABLES Banana Black beans Anise Basil VEGETABLES Brazil nuts Eat your liquids Artichoke Berries Black eyed Asafoetida Blackberry Chillies Cashews Asparagus Cherries beans Basil Burdock Eggplant Hazelnuts FAVOUR Avocado Coconut Kidney beans Bay leaves Chamomile Horse radish Macadamia The nature of your meal should be Beans Cranberries Lentils Cardamom Chrysanthemum Mushrooms Pine nuts Been sprouts Dates Lima beans Celery seeds Cinnamon Peppers (Hot) light, warm, fresh, gentle, moist and Beet greens Figs Mung bean Cinnamon Clove Popcorn SWEETENERS soft in nature. Beetroot Fruits –soaked Navy beans Cloves Comfrey Potatoes Sugar Bitter melon Grapefruits Peas Coriander Dandelion Tomato Sugar substitutes REDUCE/STOP Broccoli Grapes Pinto beans Cumin Fenugreek 1. Overeating: several meals or Cabbage Kiwi fruit Fennel Fennel FRUITS DRINKS eating too much. Carrot Lemon / Lime DAIRY Fenugreek Ginger Orange Alcohol 2. Late / heavy meals: avoid/reduce Cauliflower Mango A2 milk Ginger Green tea Almond milk solids after 6.30 PM. Celery Melons Buttermilk Herbs-fresh Jasmine GRAINS Carbonated 3. Too cold / hot. Celery leaves Papaya Ricotta cheese Lemon thyme Lemon/ Lime Oats Chocolate 4. Oils & fats. Cucumber Peaches Low fat yoghurt Licorice Lemon grass Refined items Grape juice Daikon Pears Nutmeg Licorice Lemonade 5. Fried, dried foods. Green beans Persimmon NUTS & SEEDS Parsley Nettle BEANS Orange juice 6. Anything directly from the fridge. Leafy greens Pomegranate Coconut Pepper Peppermint Chick peas 7. Colouring, additives, flavourings. Orange peel Leeks Strawberries Pumpkin Rosemary Sage Split peas Shakes 8. Concentrated/refined food (eg. Lettuce Sunflower seeds Sage Spearmint Soy beans pizza, pasta) Okra GRAINS Sesame seeds Tarragon Toor dal CONDIMENTS 9. Yeast, meat & eggs. Parsley Barley Thyme OILS Chocolate 10. Coffee, tea & alcohol. Parsnips Buckwheat DRINKS Turmeric Olive oil DAIRY Chutney, hot 11. Sugars & white flour. Pumpkin Bread -yeast free Apricot juice Salt Coconut oil Cheese Gherkins 12. Carbonated drinks. Radish Corn Cherry juice Cream Gomasio Spinach Couscous Coconut milk CONDIMENTS SWEETENERS Ice cream Pickles Sprouts Millet Cranberry juice Apple cider Honey Sour cream Vinegar Key Squash Oat bran Lemon juice vinegar Palm sugar Yoghurt low fat ✓ Favourable Sweet potatoes Pasta (rice/corn) Chocolate, bitter Molasses Butter Pineapple juice ❑ Moderately Taro root Polenta Chutney, sweet Peach juice ▲ twice a week Turnips Rice-pasta/noodle Pear juice Coriander leaves OTHERS NON VEG ✖ Avoid Zucchini Rye Prune juice Curry leaves Broth Eggs Sago Rice milk Olive Chicken Ham Seitan Miso broth Fish Red meat Parsley Soup Tamari
  9. 9. 100% Nutrition 1. Reason: Eat when you are hungry. (If you are not hungry - Important Shopping Cooking improve your digestion). 2. Eater & the • Find out all the healthy, • Breakfast: Get a good 1. This is not a balanced food: Food is appropriate to the eater. 3. diet. You are not organic shops and quality juicer. Fresh Food, chef & the eater: Wholesome food, happy chef and mindful eating. 4. absorbing a balanced diet markets near your office vegetable juice is good Four textures: Have at least 4 textures at right now. This is a light and home. for breakfast. This will least in 1 meal daily. 5. Five senses: diet that is designed to • Have a weekly shopping optimize your energy Engage all senses. We get 20% of pleasure day. Shop for grocery levels. rest your digestive system through each sense. 6. Six flavors: and optimize /your items for the whole week • Lunch should have 60% Include sweet, salt, sour, bitter, pungent and astringent in a meal. A healthy absorption. and perishables for 3-4 colored vegetables, 20% ginger-lemon pickle has five. 2. Once you achieve days. Have another mid- carbohydrates and 20% How to get sick 1. Too much acidic better digestion, you week shopping day for from your ‘favorite food: (tomatoes, vinegar, yeast...). 2. need to have a NEW perishables. healthy’ choice. Acidic eating: Not chewing enough normal diet. Diet • Always buy healthy • Soups and light salads forces our stomach secrete more acid. 3. changes as you and snacks for the car, are the best as dinner Acidic lifestyle: Rushing, unplanned life kitchen and office, especially if it is late. etc. 4. Acidic mindset: Unresolved issues your life change. and negative thoughts about them. 5. 4. You need to be under especially if you are Light dinner includes Acidic breathing: Not breathing deep supervision when you ‘snacker’. easily digestible enough. follow this diet. Any • Always store quick meals vegetables and soft carbs Health and well being articles concerns should be such as organic soups and (eg: cous cous). Download more than 12 articles written discussed. This means, salads for emergency by Rama and Caroline published in leading periodically you need to evening meals. • Do not heat / roast / magazines from our website. • Check your kitchen panfry the same meal contact your practitioner to make sure you are cupboards and throw twice as it becomes Ayurveda Elements Established 1996 getting all essential away all the food items carcinogenic. 17 Orchard Rd Chatswood Sydney 2067 nutrients that you need. past expiry date. www.ayurvedaelements.com • Steaming is the best, 5. To obtain maximum info@ayurvedaelements.com boiling is the second best results, you need to 02-9904 7754 follow it strictly. for a healthy life. Get a quality steamer.
  10. 10. Here is how I am going to do My Ayurvedic health program… It will be planned and systematic. Program My order Week/day Time • Herbs Daily As directed • Shopping Week Day • Low impact cardio Weekly 1-2-3 times … hours weekly • Cooking Frequency Time • Yoga Weekly 1-2-3 times … hours weekly • Meditation Daily At bedtime • Cleansing First one Second one Once they are scheduled, I know it is easy to do them. Total health is my goal. ………………………………………………………………………… Here is my signature. And this is my promise to myself.

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