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Telecom Consultation
Personalized phone call consultation.
Cost: ₹299/-
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Video Call Consultation
Interactive video call consultation.
Cost: ₹499/-
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Online Consultation Form
Personal Information
Full Name
Age
Gender
Male
Female
Other
Occupation
Contact Number
Email Address
City/Location
Health & Lifestyle Information
Main Reason for Consultation
Any pre-existing medical conditions?
Yes
No
If yes, please specify
Currently taking any medications or supplements?
Yes
No
If yes, please list
Sleep Pattern
Good
Disturbed
Insomnia
Digestion
Good
Occasional issues
Chronic issues
Briefly describe your daily routine
Consultation Preferences
Consultation Mode
Select consultation mode
Phone Call (₹299/-)
Video Call (₹499/-)
Preferred Language
Select language
English
Hindi
Telugu
Kannada
Other
If Other, please specify
Preferred Date
Preferred Time
Consent
I consent to the online consultation and understand this does not replace emergency medical care.
I agree to the privacy policy and terms of service.
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