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New & Prospective Patient forms

These comprehensive health assessment forms allow Khabir to prepare for and review your case in great detail before your appointment.  This process saves a lot of time and leads to a more comprehensive diagnosis.  There is no obligation or cost on your part to complete these forms.  After you complete an online form schedule your appointment OR call Khabir @ 805-308-3480 to discuss your case.  He will be pleased to review your completed form, discuss your case and answer your questions. 

Completion of an online form is not required.  If you cannot complete one of these forms online, they can be completed in the clinic before your appointment or an office assistant can help you complete the form on the phone if you can not come in to the office. 

* NOTE: Forms need to be completed on a computer or Ipad not a cell phone. 

Notess: When completing the online forms, please do so within an hour or you may have to start over.  You will need to sign and submit the form at the end.  The forms are not printable but if you want to complete a form by hand request a printable version.  If you wish to complete the form on the day of your appointment, please arrange to come 30 minutes early.

Returning patient forms

  • Returning patient assessment form: Tissues & System Assessment Form - Helpful (but not required) for returning patients after 3 months and highly recommended for returning patients after 6 months or more.

  • Daily Journal for existing patients: Daily diet & Lifestyle Journal - For active patients seeking feedback.

* NOTE: Forms need to be completed on a computer or Ipad not a cell phone. 

Your information remains completely confidential and private.*
Visa, MasterCard and Amex are acceptedPayPal is also accepted.  Checks should be payable to Natural Healing Consultants.

To discuss your case after completing a form please contact Khabir at:

Clinic Details

Days & Times

The clinic is available for last minute appointments, however, an appointment is still required.  Appointments are generally scheduled Monday through Thursday between 10:00am to 5:00pm and half day Saturday with availability on weekends and evenings upon request.

Family Consultations

Many families find they share the same health challenges and/or wish to implement lifestyle changes as a family instead of restricting healthy changes to a single member of the family. I am happy to consult with families and couples together. Bring your partner or family member to support you!

Payment Policy

Payment for services is required at the time of appointment for office clients or in advance for remote clients (i.e. Skype, email, Google Hangout, phone).  Detailed receipts will be provided by email for all services and products purchased.

Visa, MasterCard and Amex are accepted. PayPal is also accepted. Checks should be payable to Natural Healing Consultants.

Cancellation Policy

Appointments missed or cancelled in less than 24 hours will incur a $50 charge. Exceptions to this policy may be made for emergency situations on a case-by-case basis.


Teas, herbal formulas, supplements, spices, oils and other products are not included in consulting fees or programs unless specifically stated.  We use the highest quality, ethically wildcrafted, pure, and organic herbs in our herbal preparations. * Herbal product costs: Generally, $15 for a 2 oz jar; $25 for a 4 oz jar; and $35 for a 6 oz glass jar of powdered herbs; $15 or $20 for a 2.5 oz or 3.0 oz bag of loose herbal tea blends; and $15 for 4 oz of herbal oils. Prices are sometimes adjusted based on the cost of the ingredients not the weight.  (Herbal products may be shipped in plastic bags instead of glass jars.)


We do not bill insurance directly, but we will prepare a detailed bill which you can submit to your insurance company for reimbursement, if your insurance covers naturopathic or nutritional therapy visits.  We do not bill Medicare.

* Privacy

We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information.   Your personal information is contained behind secured networks and is only accessible by a limited number of persons who have special access rights, and are required to keep the information confidential. The complete privacy policy.

* Security

All transactions are processed through a gateway provider and are not stored or processed on our servers. Forms (from the links above) are available securely online and managed by, New York, NY.  (SeamlessDocs utilizes bank grade security and proprietary encryption techniques to ensure the highest level of security for your documents and data.)


Khabir Southwick is available for [face-to-face] consultations in Ojai California or remotely by phone or Skype worldwide.

Request for more information.  Fees and Health Assessment Forms

Call 805-308-3480 for more information or to leave a message. For general inquires: email


Contact Info

Office Location:
723 Fernando St. Ojai - Business licence #8111 (by appointment)

Mailing Address:
226 W. Ojai Ave. Ste 101-177 Ojai, CA 93023

Contact Info:
Office: (805) 308-3480 - Call anytime.
Skype Name: KhabirOfOjai

© 2009-2020 Khabir Southwick