Note: Medicines cannot be couriered or posted to Gulf countries & in UAE countries.
The complete process of registration is necessary for every person seeking consultation & treatment.
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Basic information as mentioned in various blocks should be filled completely & sent through email. Patient is required to send us his complete basic information like Name, Age, Sex, Date of birth, Permanent Address, Contact details. Complete postal address with postal code is to be given.
Note: Incomplete address information may lead to delay or non-delivery of medicines.
A brief write up is to be mailed regarding your complaint for which you wish to take consultation and treatment. Once the email is sent to us we will respond to you within 24 hrs & go through the payment procedure further procedure will be done accordingly. If willing one can make payment right away or wait for our reply.
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PAYMENT GUIDANCE AND REGISTRATION:
Once we confirm receipt of your mail and send you the reply, the patient is required to register himself/ herself by filling the registration form with all mandatory details and make payment through Net banking or NEFT transfer or by depositing cash/ cheque in the nearest branch of HDFC Bank.
Our Bank details are as below:
- Account Name : Cosmic Homeo Healing Centre
- Account Number : 050200012113144
- Bank Name & Branch : HDFC Bank, Raopura branch, Vadodara.
- IFSC Code : HDFC0000429
- MICR Code : 39024000801802529
Inform us about the details of payment done by you through Email and we will revert back to you immediately.
1st consultation for all patients is Rs. 500
The charges for medicines per day is Rs.40+
For 30 days medicine charges in India the charges are Rs.1200 + Courier charges as applicable.
For 90 days medicine charges in foreign countries is Rs. 4500 + Speed post charges as applicable.
Note: The facility of paying through CCAvenue is still under process. You can also pay by Debit Card.
Note: We do not accept Credit Cards.
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MEDICAL HISTORY FOR HOMEOPATHIC TREATMENT
DIRECTIONS FOR A WRITTEN SUBMISSION
Homeopathic & Holistic consultation requires all relevant information with regard to:
- The patient or person as a whole with individual attributes(mental & physical)
- Complaints-main as well as subsidiary.
- All information given to us is, of course, strictly confidential.
*It is not compulsory to send us the complete write up as per the history form but you may go through the entire form so as to be aware & prepared at the time of phone, skype or email consultation.
Please supply the following information as standard routine:
- Name in full; Date of birth; Sex; Status: Single/ Married/Divorced/Widowed since
- Addictions: Tobacco/smoking/tea/coffee/beer/whiskey & liquors(please state the quantity consumed).
- Educational career & Qualifications
- Occupation: Current & previous with a description of responsibilities & job-satisfaction.
- Description of current family set-up: Full details pertaining to all the members, their ages,location,work they are doing & your relationship & responsibilities for them. Include in your list those who have died, stating the age at death, time/date of death & the cause for the same.
- Your daily routine from getting up in the morning to retiring at night. Include in this your dietary schedule furnishing full details in respect of the quantities consumed.
- Financial responsibilities & strains (present as well as in past)
- Difficulties experienced: At place of work/family set-up/Social-give a full account.
Describe fully what bothers you most. Each trouble should be detailed as under:
Full description of the trouble right from the time of onset, its subsequent development & spread & response to treatments taken. This should give a full idea of:
- Area affected: location, extension, direction of spread, the march of events.
- Sensation experienced in the area of trouble.
- Conditions that have brought on the trouble: examine the circumstance that was present just before the onset or at the time of onset, paying attention to physical as well as emotional factors.
- Conditions that increase the trouble or those which afford relief.
- Other troubles experienced at the same time along with the main trouble: for example-perspiration/nausea/vomiting/gas etc.
Describe here all other troubles you might be having or have had in the past. Each should be described fully as suggested above for the Chief complaints.
Give full account of the following:
- Physical description of self
- Emotional nature & intellectual attainments & aspirations. Indicate to what extent you have been able to realize them. Give a clear picture of your relationships with the family members, friends & associations & also a full idea of your responsibilities & what you feel about them.
- Reactions to surroundings-
A) Food: desires & aversions, foods that do not suit,etc.
B) General environment: weather, temperature, bath, recreations, addictions etc.
C) Sleep & dreams
D) Sex (inclusive of menstrual & obstetric history)
Give a detailed description of the various illnesses you have experienced & had in past & to what extent they have a bearing on present troubles. Also detailed information about any surgeries performed on you in the past.
Data concerning your parents, siblings & if possible also Grandparents. State details concerning the health of wife/husband & children.
Include here anything which you have not mentioned above or would like to share with us.
- Medical reports & opinions on your state of health from your physician.
- Copies of reports & investigations done.
- X-ray plates, Electrocardiograms etc.
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INTERVIEW AND CONSULTATION:
Once your history form is with us we will respond to you in 2-3 working days & inform you about a time and date for consultation which may be either through phone or skype.
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