Book a Medical Consultation
Select your doctor, choose a date and time, and complete payment if required to confirm your request.
Patient Details
Patient Full Name
*
First Name
Middle Name
Last Name
Phone / WhatsApp Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
Other
City
*
Height (cm)
*
Weight (kg)
*
Known Allergies
*
Current Medications (if any)
Consultation Concerns and Ratings
Primary health concern and reason for consultation
*
Sleep quality
*
1
2
3
4
5
Pain level
*
1
2
3
4
5
Upload medical reports or prescriptions
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Doctor Selection and Appointment
Choose Your Doctor
*
Please Select
Dr. Lalith Kumar G – ₹1,000
Vaidya Preeti Bhosle – ₹750
Dr. Niki Ravi Kumar – ₹800
Dr. Akshay Shah – Veterinarian – ₹500
Dr. Shaikh – Free Consultation
Appointment Date
*
Appointment Time
*
Hour Minutes
AM
PM
AM/PM Option
Veterinary Details
Pet Name
*
Animal Type
*
Please Select
Dog
Cat
Bird
Rabbit
Reptile
Other
Breed
Pet Age
*
Pet Weight
*
Pet’s Primary Concern
*
Consent and Payment
Consent
*
I confirm that the information provided is accurate and consent to being contacted by Cure By Design and the selected doctor regarding this consultation.
Confirm Consultation
Should be Empty:
prev
next
( X )