Online Counselling

Please first visit www.YogaPranayama.com & search very carefully for more information on your specific Diseases/ Ailments etc. and its complete package for treatment, with ayurvedic Herbal Medicines & VCDs/ DVDs on specific Yoga Pranayama regimen to cure your disease/s.

Please first visit www.YogaPranayama.com for more information on your Diseases/ Ailments etc..

Also must visit the following pages, to get the proper treatment for your medical/ mental condition/s.

For Package For various Diseases- Complete prescriptions of Ayurvedic Medicines from Swami Ramdev's D Y M Trust, please search for your specific disease online at: http://www.yogapranayama.com/Package_for_various_Disease.htm#Package

Also please search for your disease specific VCDs/ DVDs and Books etc. by Swami Ramdev online at: http://www.yogapranayama.com/swamiramdevdvd.htm

For Specific Individual Ayurvedic Medicines from Swami Ramdev's D Y M Trust, please search for your specific Ayurvedic Medicines, by their specific names, online at:
http://www.yogapranayama.com/swamiramdevmedicines.htm

Please order the same online & get back to us for the rest, we shall send you the online Invoice for the same, via the secured payment gateway.

Please get back to us on phone, if there is any ordering or payment hassle.

Also please send the following information on your each patient separately, duly
completed, via email to YogaSale@gmail.com for record/ statistical
purposes.

(Please "Copy & Paste" this form in you Email browser; then fill it up &
send to: YogaSale@gmail.com )

All personal information shall be kept strictly confidential. We do not
share your email IDs with anyone. ::
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Case Record Sheet for Online Counselling

The answers to the questions, like name & other inconvenient/ irrelevant
questions of personal nature, my be left blank, as it is optional.

Name ::

Gender :: Male Female

Age ::

Marital Status ::
Profession/ Job Role ::

Full Postal Address ::

City & ZIP/ PIN Code ::

State ::

Country ::

Landline Telephone: (Country Code - Area Code - Phone ) ::

Mobile / Cellular Phone: (Country Code - Area Code - Phone ) ::

Education ::

Email ID ::

Alternate Email ID, if any ::

Your Skype ID, If any (visit www.Skype.com to get your ID) ::

Blood Pressure ::

Weight :: Kg .::

Height :: Feet Inches ::

Are you a: :: Vegetarian Non-Vegetarian ::

Dependence on :: Alcohol Drugs Smoking Coffee/Tea ::

Major Ailments/ Diseases::

All other Ailments ::

Presently taking treatment for which Diseases ::

Personal History ::

Family History ::

Describe your family history in brief (profession, and diseases) ::
Do your disease symptoms decrease or increase when you change places having different climates? ::
Give details about your addictions/cravings, if any, like tea, coffee, alcohol, sugar, smoking, drugs etc. ::
How would you describe yourself emotionally? ::
What time do you usually go to sleep? When do you wake up? ::
Why do you want to try Yoga Pranayama & Ayurveda? ::
Do you want to give any other information? ::

Laboratory Investigation Reports (if any) ::

USG/MRI/Scan Reports (if any) ::

Other information which you think might be helpful ::

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Please first visit www.YogaPranayama.com for more information on your
Diseases/ Ailments etc..

For online counselling, any clarifications etc. may voice chat with us FREE with yogasale@gmail.com via Google or leave us a voice chat/ text chat message via your Multimedia P C

or Get Skype from http://www.skype.com/intl/en/download/skype/windows/ and call us for FREE using the "I am Online" Skype link on the right of this screen or leave us a text chat via your Multimedia P C.

Calls from NGOs, Medical Professionals, friends, relatives & associates of
the affected people are welcome.

Callers identity is kept strictly confidential.

________________________________________________________________________________________________________________

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