A Model Guru: Casting Application and Questionnaire
Suffering from a Chronic Ailment?

Then our new TV series wants to hear from you!

Veria Living Network is looking in the Denver and Los Angeles areas for men & women suffering from chronic ailments (e.g., consequences of menopause, depression, autism, PTSD, veterans’ issues, diabetes, infertility, etc.) to be featured in its hit show “A Model Guru.”

People selected for the series will receive a complimentary consultation and wellness plan created and supervised by Yogi Cameron Alborzian, former supermodel-turned-Ayurvedic healer. Ayurveda is an ancient Indian system of holistic treatments that helps restore the body to healthy balance.

Check out Yogi Cameron on Facebook or at yogicameron.com. Yogi Cameron is a frequent guest on The Dr. Oz Show, The Ellen DeGeneres Show and The Today Show.

Our goal is to promote wellness by capturing the struggle and transformational process possible through Ayurvedic practices and treatments.

Taping starts in September in Denver and October in LA. Ideal candidates will be emotionally honest and open to Ayurvedic treatments. Veria Living Television Network is dedicated to healthy living.

Applicant Contact Info:
Legal Name:
Name your friends call you:
Date of Birth (MM/DD/YYYY)*: *For verification purposes only pursuant to 18 U.S.C. 2256 et seq
Occupation:
Street Address:
City, State & Zip:
Home Phone #:
Cell Phone #:
Email:
Children (if applicable) names and ages:
Spouse/Partner name and age:
Pets:
Applicant Questions:
Describe your current ailment(s). Please give specific examples, including symptoms: (Please attach additional pages if necessary for this and all subequent questions)
How long have you been suffering from your ailment(s)?
How does your ailment(s) affect your daily life?
Has your ailment(s) been diagnosed as life-threatening or terminal? If yes, please explain.
What methods have you used to treat your ailment(s)?
How much time did you devote to each method?
Which treatment(s) put you the most out of your comfort zone?
Who is your biggest support while dealing with this ailment?
What is your relationship to this person/people?
How will he/she keep you motivated through this process?
Has your ailment(s) affected your personal and/or professional life? If so, please describe:
What have you given up/sacrificed because of your current ailment(s)? Example: missed event(s), family time, vacation.
On a scale of 1-10, how would you rate your current level of distress over your medical condition(s)?
How willing are you to open up emotionally on camera to a professional yogi/alternative health care provider?
Describe your diet and exercise plan, if any. If no plan, please describe your typical diet and any exercise you do.
Please provide an example of something (other than your ailment(s)) that you struggled to overcome. Have you overcome it? Why or why not?
Which best fits your thoughts on ancient Eastern healing practices (feel free to expand): ie, 'I know nothing and am open to learning more.' ' I am familiar and have not tried anything.' ' I’m hesitant.' ' I’m familiar and have dabbled.'
What has influenced your decision to try something other than Western medicine to improve your health (have you reached your last straw / hit rock bottom)?
What is the best possible outcome you can imagine for yourself, if you weren’t suffering from your ailment(s)? IE: Fill in the blank: 'If I were at my best I would______________________________________.'
Why do you want to participate in this television program?
Have you ever been on television before? If yes, please list when and the name of the program.
How did you find out about this program?
Please include 3-5 photos of yourself and the person or people who will support you throughout this process.
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