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E-Consultation
 

Ayurveda :

VEDIC TREAT conducts training programs in Bangalore and Kerala for those who are interested in learning Ayurveda and Traditional Ayurvedic treatments. more...
 

E - Consultation

If you are suffering from any ailment and want to consult Dr.Sanjeev, you can fill and submit this form. Dr.Sanjeev will answer your query.

Name :

Gender :

Age :

Address :

Land Phone :

Mobile :

E-mail :


Health Complaint (Explain complete symptoms and since how long you have been suffering):


Family History (About your parents, siblings, their age and their health problems if any):


Present Medications if any along with duration of the medication:


Past Medical History (If you were hospitalized or have been under some medication since a long time):

Lab Investigations(if any)"


More about you :

Weight :

( in kg)
Height :

( in feet )
Built :

Skin Complexion :

Hair Colour :

Hair Texture :

Eye Colour :

Nail Colour and Texture :

Urine : Frequency :

Colour :

Odour (if any) :

Stools :

 
Tongue : Taste :

Colour (if there is any coating) :


Whether at your place (If Indian, just mention your place) :


Habits (if any) :                

About Food Habits (Explain complete food diet and timings of food, passing of stools, etc.):

Details about Sleep :

About your profession :


Are you practicing any of these?                Yoga       Meditation       Exercises


If yes, how many days a week and duration in a day :

If you need treatment, for how long can you stay at VEDIC TREAT?
 
   
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