Applicant Name:_Sanjay_Pisharodi Document 3: Statement of Practice Instructions: Please complete the following information as completely as possible. Please describe the physical setting of your office or clinic: (e.g, shared office in medical building, etc.) From August 2013 to June 2014 | had my own office in a separate building within the campus of Kerala Ayurveda Hospital and River Retreat in India “In October 2014 | established a new Ayurvedic Depariment at Food for Life Medical Center in Vrindavan India, _Lam also working towards establishing another Ayurvedic Resort in Kerala at Wayanad which will begin “functioning in October 2015. Average number of hours per week worked practicing Ayurveda: __ Forty eight hours (48 hours) What is your specialty or the focus of your practice: Ayurvedic Oncology, Gastrointestinal disorders, Joint and spine disorders, Neurodegenerative disorders and Gynecological & Obstetric disorders. “Talso especially focus on detailed documentation of clinical cases and outcome for the Stz purpose of Statistical and “Observational studies. : Additional information that presents a full and accurate description of your Ayurvedic practice: Lworked as an Ayurvedic Consultant at Kerala Ayurveda Hospital and River retreat from August 2013 to June 2014,__ During this time | managed patients in the Outpatient department. supervised treatments in the Inpatient department taught interns coming from Kerala Ayurveda Academy USA for the India internship program, designed Ayurveda Course modules for the Kerala Ayurveda Academy USA and was one of the key team members to ensure quality of treatment and education. “Later | tained at the National Research Institute of Panchakarma (NRIP), a Central Govemment Research Institute “specializing in training and research of Panchakarma techniques, from July to September 2014 (for three months). “During this time | performed hands on Ayurvedic treatments and therapies for 48 hours a week. After completion of this, | established the Ayurvedic department in Vrindavan, India. |, SANJAY PISHARODI (name), hereby state that as of _24TH JULY 2015 (date), Thave managed a minimum of 50 cases in my Ayurvedic Practice. I further confirm that I have practiced Ayurveda in india for Two years. SANJAY _PISHARODI Signature Printed Name 24TH JULY 2015 Date Document Completed ‘8605 Santa Monica Ble #46789, Ls Angeles, CA 90069-4109 wwwayurvedaNAMArg | emailusat:info@ayurvedaNAMAorg