Patient Questionnaire

    TRAVEL DETAILS
    DATE OF ARRIVAL IN BANGALORE
    DATE OF DEPARTURE FROM BANGALORE
    REPORTS
    WHAT DOCUMENTS DO YOU HAVE?
    EARLIER VISITS
    HAVE YOU VISITED US BEFORE?
    HEARD ABOUT US?
    IN BANGALORE TRANSPORT AND STAY
    HAVE YOU ARRANGED HOTEL
    DRIVER
    ASSISTANCE
    DO YOU NEED ANY PROFESSIONAL ASSISTANCE IN
    BOOKINGS AT HOTELS/SERVICE APARTMENTS
    TRANSPORT IN TAXI WITH PROFESSIONAL DRIVER
    ANY OTHER HELP OR CLARIFICATION OR ADVICE
    WHAT TREATMENTS DO YOU WANT?
    BONE/JOINTS
    NERVES
    OZONE/CHELATION
    STEM CELLS
    OSTEOPOROSIS
    STROKE REHABILITATION
    ANY OTHERS

    Please click on the following button to fill out the Patient Questionnaire form.

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