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Consultation Process

Since Cure Veda Clinic is about providing holistic and individualized treatment, the Consulting Procedure is crucial to understanding the specifics of your physical, mental, and spiritual aspects. Enter your medical details in the chart given below. It would help you have a brief and quick discussion before opting for the detailed consultation.

Consultation Form
Your Personal Details 

( * Fields are mandatory)






Email Id*



 Feet    Inches


Your Health Details

Name your disease, chief signs, symptoms (as diagnosed by conventional/modern medicine)

General Diet

Diet details

Complete History of Disease

Do your symptoms/complaints decrease or increase when you change climatic zones?

What kind of food, lifestyle or environmental changes relieve the nature of your complaints?

What kind of food, lifestyle or environmental changes trigger the symptoms of your disease?

Digestive System

How is your appetite and digestion?

Give complete details of your bowel movements, such as time of evacuations, frequency, color, consistency, regularity, irregularity and smell.

Do you see any Mucus in your stool?

How often do you have constipation and what do you think are the causes?

Do you pass wind?

  Do you have acid reflux/heartburn?
  Do you experience heaviness, discomfort or  
  pain in the stomach after eating?
Urinary System

What is the frequency, quantity and color of your urine?

Do you feel any burning sensation while urinating?


Do you sleep soundly?

Mental Condition:

How would you rate yourself emotionally?

(press 'ctrl' and click for
multiple selection)

How do you perceive your own financial status? What are your comfort levels with your current situation?

Your Treatment History  

What types of treatments and medicines have you taken so far?

What have been the results?

Have you observed any side-effects?

How much do you know about CureVeda?

Reproductive System

Mention, if you have any sexual problems

Are there any other details you would like to share?



What is cure Veda clinic?"Cure Veda" is the treatment and Cure with Ayurveda.