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Informed Consent

 

By registering for any free or paid service(s) on www.myayu.com, or any of its pages, I agree to have read the following, and understand it completely. I state that I am an adult desiring Ayurvedic consultations (free or paid services) through AyurvedaFirst, PBC, or any of its staff or representatives, and I hereby acknowledge the following:

 

1.     That Ayurveda is a traditional healing system originating in India and bases itself on principles that each individual’s constitution and path to optimal health is unique.  It was developed and practiced over thousands of years and continues to play a major role in current health care in India and other parts of the world where it is recognized as an independent system of medicine.  In the United States of America it is not taught universally in medical schools, although advanced training programs are available at specialty schools in the US.

2.     That the National Center for Complementary and Alternative Medicine (NCCAM), an office of the National Institute for Health (NIH), considers Ayurveda a form of Complementary and Alternative Medicine in the United States.  It does not require a license to be practiced in any of the 50 states.

3.     That AyurvedaFirst, PBC, is not a Medical facility, and its Ayurvedic Practitioners are not Medical Doctors.  Any counseling, recommendations or information conveyed by AyurvedaFirst, PBC or its staff or representatives is not a substitute for professional advice from a Medical Doctor.  Any examination techniques performed are done so from an Ayurvedic perspective only, even if they might appear similar to a routine Medical Examination.  This in no way constitutes a replacement for a professional Medical evaluation.

4.     That Ayurvedic consultations include a comprehensive review of my personal information, diet, lifestyle, habits and any related details.  Ayurvedic therapies involve constitutional analysis, diet and lifestyle counseling, Ayurvedic body treatments, herbal therapies, meditation and breathing therapies, Yogic exercises, sound and color therapy, relaxation techniques, and PanchaKarma detoxification methods, all of which can vary and be recommended based on the practitioner’s best judgment.

5.     I understand that any and all of my personal information provided to AyurvedaFirst, PBC will be kept completely private and only shared with the Practitioner(s) who consult with me.  My information will never be sold or provided to any other person(s) or parties.

6.     I further acknowledge that I am not seeking or undergoing Ayurvedic therapies as a result of any inducement or representation or promises made by the Ayurvedic practitioner or any other person(s).

7.     I acknowledge that no warranties or guarantees have been made to me, expressly or implied, for any results or outcomes based on any services at AyurvedaFirst, PBC.

8.     I wish to proceed freely and voluntarily with such therapies and authorize the practitioners and/or staff at AyurvedaFirst, PBC to proceed with such recommendations and/or therapies with the full and informed consent on my part of all the relevant facts as set forth in this consent form.  I solely represent myself and am not appearing on the behalf of, or representing any third party or parties. This consent shall apply to my initial and all subsequent Ayurvedic consultations, therapies and interaction with any representative(s) of AyurvedaFirst, PBC.

 

In addition to the above, the California Health Freedom Act (SB-577) requires that any alternative health practitioner in the state of California provide the following information:

(from ftp://www.leginfo.ca.gov/pub/01-02/bill/sen/sb_0551-0600/sb_577_bill_20020923_chaptered.html)

SECTION 3. Section 2053.6 is added to the Business and Professions Code, to read:

2053.6. (a) A person who provides services pursuant to Section 2053.5 that are not unlawful under Section 2051, 2052, or 2053 shall, prior to providing those services, do the following:

(1) Disclose to the client in a written statement using plain language the following information:

A) That he or she is not a licensed physician.

(B) That the treatment is alternative or complementary to healing arts services licensed by the state.

(C) That the services to be provided are not licensed by the state.

(D) The nature of the services to be provided.

(E) The theory of treatment upon which the services are based.

(F) His or her educational, training, experience, and other qualifications regarding the services to be provided.

(2) Obtain a written acknowledgement from the client stating that he or she has been provided with the information described in paragraph (1). The client shall be provided with a copy of the written acknowledgement, which shall be maintained by the person providing the service for three years.

 

In accordance with the stated law, AyurvedaFirst, PBC, declares the following:

1.  That none of its Ayurvedic Practitioners are licensed physicians in the state of California or any other state in the US.

2.  That Ayurvedic practices, programs and treatments are alternative or complementary to healing arts services licensed by the state.

3.  That Ayurvedic services are not licensed by the state of California or any other state in the US.

4.  The nature of the services to be provided are individual (one-on-one) consultations with an Ayurvedic Practitioner who has been licensed as an Ayurvedic Physician in India.  Consultations include a wide range of health-related discussions, topics and recommendations that may cover (but are not limited to) diet, lifestyle, exercise, relationships, mental disposition, supplementary herbal formulations (oils, powders, tablets, decoctions, and more), external body treatments and other special protocols like short-term diets, cleanses and Pancha Karma.  The recommendations made are on a case-by-case basis and are made solely based on the information provided by you (the client) during the consultation.

5.  The Ayurvedic services offered by AyurvedaFirst, PBC are performed by individuals who have completed a minimum of 5.5 years of Ayurvedic education in India, and who have successfully graduated as an "Ayurvedaacharya" with a degree of "Bachelor of Ayurvedic Medicine and Surgery."  Each individual will be licensed by an Indian Ayurvedic state board and legally allowed to practice as an Ayurvedic Physician in India.  Some Practitioners may have additional, advanced training, including, but not limited to, a 3-year post-graduate degree - MD (Ayu) - with specialization, and a PhD (Ayu) with specialization.

 

By registering on this site (www.myayu.com), you ("the Client") agree that the information required by SB-577 has been provided to you in full, that you have understood it and that you agree to it.  Your registration on this site indicates your agreement.

 

At any time, you may print this page for your records.  Should you chose to do a personal consultation through www.mayu.com or AyurvedaFirst, PBC, your information and agreement to this Informed Consent will be stored for the time period required by law.