The Cleanse Teleclass

Registration

Cost: $455.00 includes shipping via FedEx and taxes.
To register either:

1) Call 1-800-563-3327
2) Email deva@newmexico.com with your credit card number, expiration date and name
3) Mail a check or postal money order payable to The Cleanse at PO Box 1515, Santa Cruz, NM 87567
4) Register on-line www.thenewcleanse.com/prepquestionaire.doc

How Do I Get on the Teleclass?

Upon receipt of your registration payment you will be emailed the secret Teleclass bridge line number. You do not need a computer to be on the call. Please call this number at the appointed time, and you will be on a group conference telephone call. It's easy!

Kartar S. Khalsa, D.O.M.

Kartar S. Khalsa combines the expertise of a licensed Doctor of Oriental Medicine, a trained Acupuncturist, and a KRI Certified Kundalini Yoga teacher. He currently practices herbology and acupuncture at the GRD Health Center in New Mexico. Over the last seven years he has guided over 1,200 people through The Cleanse, as well as participated in the program 23 times himself. Kartar Khalsa, DOM possesses a personal passion for The Cleanse. His dynamic abilities as a healthcare professional and a compassionate advocate of yogic technology have been inspired by his spiritual teacher, Yogi Bhajan, Master of Kundalini Yoga.  He has practiced a yogic lifestyle for 17 years, Acupuncture and herbology for 11 years and conducted group and private cleanses for 7 years.
You are about to embark on a journey of self-discovery. To prepare yourself for The Cleanse:
  1. If you are using any of the following: caffeine, nicotine, non-prescription drugs, alcohol or any other addictive substances, or if you consider yourself toxic it is very important that you speak with Dr. Kartar before you begin so he can help you design a preliminary program.
  2. Read the entire manual before you begin. For at least one week prior: favor freshly prepared, wholesome and nutritious foods.
  3. Minimize canned foods and leftovers from previous meals.
  4. Favor lighter foods such as vegetable soups, tofu, quinoa, millet.
  5. Minimize fried, greasy and oily foods.
  6. Reduce the consumption of meat, dairy products and refined sugar.
  7. Eliminate soda, alcohol, cigarettes and coffee.
  8. If you are a coffee drinker, switch to green tea which is high in antioxidants and still has some caffeine. Green tea contains substances called catechins that lower cholesterol and protect against cancer. It is the most healthful of the caffeinated beverages.
  9. Drink the master cleanse daily. Recipe: one quart of purified water, one shaved lemon (save as much of the white pith as possible), one pinch of cloves and 1 1/2 tablespoons honey, real maple syrup, barley or rice malt syrup. Place all ingredients in a blender and blend for 20-40 seconds. No straining necessary.
Please help us help you by providing us with the information below and fax or email this form back to us.

Name____________________________________________________________________

Mailing Address __________________________________________________________

City ______________________ State: ___________ Zip-code: ____________________

Home Tel ________________ Bus Tel __________________ Cell __________________

Fax ___________________ Email ____________________________________________

What do you hope to learn by doing The Cleanse/what are your personal cleansing goals?___________________________________________________________________

What is your occupation____________________________________________________

When do you plan to start The Cleanse? __________________________________

Health Information
What is your current lifestyle? (i.e. stress level, yoga, healing practices, etc.) ________________________________________________________________________

What is your weight? __________ Height? ___________ Age? ________

Caffeine
Do you drink coffee? Yes___ No____ If yes, how many cups per day? ____ For how long? _____ Or any other caffeinated beverage or pill? ____________________________

Smoking
Do you smoke? _______How much? ____________For how long? ____________

Drug & Alcohol Use:
Do you or did you in the past ever drink alcohol on a regular basis? Yes____ No____ If so, when, for how long a period of time and how much?

Did you ever use non-prescription drugs? Yes____ No____
If so, which specific drugs, when and for how long a period of time?

Diet
(Please check the diet you are eating)
Low fat diet___ Diabetic diet___ Vegetarian diet___
Normal American Diet___ Heavy Meat Diet___ High Sugar/Fat Diet___

What have you eaten and had to drink in the past 24 hours?

Do you shop at a health food store?

Exercise
Do you have any regular exercise program? Yes_____ No ____ What is it?

What exercise(s) have you had in the previous week?

Elimination
Do you have any problems with urination? Yes____ No____

Do you get up in the middle of the night to urinate? Yes___ No____

If yes, please describe in some detail. (for example: frequent urination, night urination, difficulty urinating, frequent bladder infections, etc.)

Do you have any difficulty with your bowel movements? Yes____ No____

How often do you have a bowel movement? _________________________________

Do you use any products to help with your bowels? ___________________________

If yes, please explain. (for example: I have a problem with constipation, or diarrhea, or both, or there is blood or mucous in the stool, etc.)

Prescription medicine: (Please state the medicine and the purpose for taking it)
Are you currently taking any medications? Y or N

If so which ones?

Are there any medicines, herbs or supplements you have taken a lot of in the past? If so: which ones, how much, and what were they used for?

Do you have any disabilities? ________________________________________________
Cancellation Policy

Cancellations must be submitted before The Cleanse is sent out to you and a $50 processing fee will be deducted from your refund. Once The Cleanse has been sent out or received by there is no opportunity for refund.

Disclaimer

The Cleanse is not to be used as a substitute for qualified medical care. Over the ages many people have received benefit from the underlying principles of these ideas and products. This is no guarantee, however, that you will have the same results. It is essential that any participant who has any reason to suspect serious illness seeks appropriate medical advice and care promptly. Remember: Always consult your primary health-care practitioner before undertaking any exercise, dietary or herbal treatment program.

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