Ayurveda Intake Form

What is your dosha?  Understanding our "dosha" helps us understand our tendencies to go out of balance from our natural constitution, who we are at our best self. Understanding ourselves in this way, allows us to feel more in harmony with our spiritual and physical belongingness.

Find out what your dosha is.  Fill out this form.

What to expect from the initial consultation. 

During your inital consultation we will go over basic ayurvedic pincibles and self care choices that can improve your health and life.


According to Ayurveda, the key to health is in understanding our own personal body type. There are three basic constitutional types, "doshas" in Sanskrit: Vata (or V), the "air" type. Pitta (or P), the "fire" and Kapha (or K), the "water" type. Each of us has some of the characteristics of all three of these. Many of us are dominant in more than one dosha.


In general, Vata people are sensitive and cheerful, quick to adapt to any new situation with enthusiasm. They crave excitement and stimulation, and are often the life of the party. They are quick in thought and in movement, seem to walk a little above the ground, and can be everywhere at once. They may be spacey, lacking in concentration skills, and may not have staying power in projects they begin with zeal. Their energy level is erratic. Physically, are slight and slender. Under stress, they tend towards anxiousness and worry.


Pitta people are bright and brilliant, intense and intelligent. They are very practical, doing what needs to be done with focus and determination. They tend to be ambitious and goal oriented, succeeding through sheer force of will. They are fair minded and logical, and can think through any problem step by step. They are forceful in their relationships, and communicate with directness. They tend to be organized, and their lifestyles are well paced and thought out. Physically, they are of moderate build, and usually have bright, intense eyes. Under stress, they tend towards frustration and anger.


Kapha people are loving, compassionate, and caring, often choosing lives of service. They have calm, patient, and stable personalities, and happily follow a regular routine. They enjoy the peace of home, and cultivate life's comforts and pleasures. However, they have an innate strength, and work very hard at whatever is truly important to them in a stable and consistent way. They tend to be cautious, committing themselves only after deliberation, but once they have committed they devote themselves entirely. They tend to avoid change, preferring instead the predictable. They tend to move slowly, and conserve their energy. Physically, they are strong and stout. Under stress, they tend towards lethargy, and may have grief or attachment.

 

When doshas become aggravated, illness results. Each dosha has certain types of illnesses associated with it, for example, ulcers are a common Pitta concern. Also, each dosha has its own unique approach to management, suh as personalized diet and lifestyle recommendations. Knowing what our body type is, therefore, the first step toward understanding what behaviors and therapies are correct for us.

Traditionally, ones natural constitution is most easily revealed by fixed attributes of the physical body.  Frame, weight, complextion, general state of digestion, metabolism, life long habits and proclivities and disease tendancies.  


Two other words its helpful to know:

Prakriti: Is the natural constitution of the individual. The nature and tendencies you were born with. (So we can look at Prakriti as the birth condition).


Vikruti: Is the disturbance of the natural constitution that is most often due to a lifelong process of habits and lifestyle practices that are in opposition to our unique nature. Vikruti is the end result of living out of harmony with our true nature. (Vikruti may be seen as our life condition) i.e. the end result of our reactions to the life experience.


To get the best assesment of your natural consititution.  


Please check any and all that apply to you.

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Information on working together.

All Clients who participate in Ayurvedic healthcare through Merritt Massage and Yoga should be advised of the following information:

Your Ayurvedic Health Practitioner will work with you on the promotion of optimal health and well-being. Please note that your practitioner will not be working with you on specific Western medical diagnosable symptoms or diseases. 

By changing your lifestyle and living more harmoniously with the cycles of nature, you will create within your body the optimum environment for healing to take place and a greater sense of well-being that will help you to thrive (and not simply survive). 

If you are under medical care or the care of another healthcare provider, your work with your Ayurvedic Health Practitioner will complement the work being done by your other providers.

If you are not under the care of another healthcare provider, the work that you do with your Ayurvedic Health Practitioner will help prevent further disease and will support your overall well-being.

Your Ayurvedic practitioner is not a medical doctor, is not trained in Western medical diagnosis, and may not prescribe or alter your prescription medications. 


While your practitioner may take your blood pressure and vital signs, and may perform some examination techniques similar to a routine medical examination, your practitioner is evaluating his/her findings from an Ayurvedic perspective only and not from a Western medical perspective. This examination does not take the place of a medical evaluation. If, as a result of this examination, any findings suggestive of a possible medical imbalance are found, your practitioner will refer you to a Medical Doctor for further evaluation. 

By signing below, you give your permission to Merrit Massage and Yoga to use the information in your chart for research purposes. (Note: no patient names, addresses, phone numbers, or email addresses are included in research records.) 

I have read and understand the above information and give my permission to begin a program of health promotion with an Ayurvedic Health Practitioner.

Schedule

New Clients Please fill out a New Client Form and Read our Policies before scheduling.

Testimonials

Massage Therapy

As a chiropractor, I've had the opportunity to work with and to have been worked on by a number of massage therapists. I rank Jen Merritt among the very best. She is deceptively strong and intuitive. She is reliable, friendly and can put anyone at ease. She has helped me when I've been in pain and other times, when I just needed to unwind and relax. I have no reservations recommending her, as I know anyone would be pleased with her skills and personable demeanor.


Dr. Hank Finkel, D.C.

Couples Massage Class

Jen,
Just wanted to thank you for the wonderful class tonight. I think that was the most relaxed I have seen my husband, Bill, in a long time. We are looking forward to practicing at home. We both gained a lot of confidence in massaging each other and I know Bill is much more open to massage now, in both receiving and giving.

Thanks Again, Janelle

Yoga

I value Jen for her extraordinary ability to teach body awareness through her gentle yoga classes. As an older athlete (61), I can apply the knowledge across all of my other activities--from strength training to swimming, running and cycling!

Thanks Jen!


Review from Yelp - Donna G.

Massage

I am a regular client of Merritt massage.  Jen is fabulous at a variety of different massage therapies.  No matter what the issue I'm having, i.e. a cold or if I have work stress, she has a massage therapy to help!  I feel comfortable with her, and I leave feeling refreshed and stress free.  I highly recommend her as a massage therapist as well as a positive inspiration


Review from Yelp -Amy L.