Dhanvantari Institute offers ayurvedic remedies for a variety of ailments both by oral ayurvedic medication as well as panchakarma method. Individual Programs are required for each person so it is impossible to list all the types of solutions that are possible. Please fill the form to obtain information on how you can benefit from ayurvedic medicine. Though the consultation is free, there will be a fee for medicines sent or for panchakarma procedures. Also consultation via video-conferencing will have a fee of Rs.500/- for Indian Patients and US$15 for foreign patients.

Please fill in all the details. Incomplete forms wont be replied to.

Patient Form    

  About yourself  

Name   

Birth Date        

First     

Middle 

Age

Last     

Gender 

Main Complaint                   

Contact Information  

Address

 

City State Pin/Zip

Country 

Home Tel.   Fax     

Work Tel.   e-mail 

Constitution:                                                            

Climate at place of residence:                                

Occupation:                                                              

Climate at place of work:                                        

History of previous major illness (if any):              

Present medication (if any):                                    

Normal diet:                                                             

Bowel movements:                                                  

Any other factor you think may help in diagnosis:

Would you like to have a video-conference*

*Details of payment and method of video-conferencing will be provided later. Providing this facility solely at the discretion of Dhanvantari Institute.                          

Timings for video-conferencing will be based on Indian Standard Time (IST). IST is GMT+5:30.


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