Join the Cure By Design Doctor Network
Share your professional details and collaboration preferences so our team can review your application.
Personal Details
Full Name
*
First Name
Middle Name
Last Name
Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
WhatsApp Number
Same as mobile number
Email Address
*
example@example.com
City
*
State
*
Please Select
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Other
Professional Details
Professional Qualification
*
Please Select
BAMS
MBBS
MD
MS
BHMS
BDS
MDS
Physiotherapist
Veterinarian
Veterinary Specialist
Other
Specialisation / Area of Practice
*
Medical or Veterinary Council Registration Number
*
Years of Experience
*
Please Select
Less than 1 year
1–3 years
4–7 years
8–15 years
More than 15 years
Clinic / Hospital / Organisation Name
Clinic Address
Collaboration Interest
How would you like to collaborate with Cure By Design?
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Join the Doctor Network
Offer online consultations
Offer in-person consultations
Support customers in my city
Collaborate through my clinic or hospital
Attend product and educational training
Conduct webinars or awareness sessions
Explore research or product-development opportunities
Receive information about cannabinoid medicine
I am not sure and would like guidance
Are you currently available for online consultations?
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Yes
No
Maybe, depending on the arrangement
Are you currently available for in-person consultations?
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Yes
No
Only within my city
Which areas are you most interested in?
Sleep and stress
Pain management
Neurological wellness
Palliative care
Appetite and nausea
Mental wellbeing
General wellness
Veterinary wellness
Functional wellness
Other
Additional Information
Languages Spoken
English
Hindi
Kannada
Tamil
Telugu
Malayalam
Marathi
Bengali
Other
Professional Website
LinkedIn or Social-Media Profile
Why would you like to collaborate with Cure By Design?
Upload Medical Registration Certificate
*
Upload a File
Drag and drop files here
Choose a file
Cancel
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Consent
Declaration
*
I confirm that the information provided is accurate
I acknowledge that joining the Cure By Design Doctor Network does not require prescribing, promoting, or recommending any product
I understand that all medical decisions remain my independent professional responsibility
Consent to Contact
*
I agree to be contacted by Cure By Design via phone
I agree to be contacted by Cure By Design via WhatsApp
I agree to be contacted by Cure By Design via email regarding this application and relevant professional opportunities
Submit Application
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