The word Ayurveda is formed by the combination of two words - "Ayu" meaning life, and "Veda" meaning knowledge
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Wisdom of Indian Sages, Adopted for Modern Ages...

For online diet consultation, kindly fill the given form. Your information will be kept confidential and private.

Diet Consultation form

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Weight Kg
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Diet: Vegetarian Non-vegetarian Eggatarian
Habits Smoker Non-Smoker
Alcohol: Nil Occasional frequently
Physical activity: Nil Occasional regularly
Existing Medical history (if any)
Are you taking any nutritional supplement: Yes No
Are you allergic to any food/foods: Yes No
If Yes, describe
Consumption of Tea or coffee: Yes No
Appetite: Poor Good Very Good
Number of meals usually consumed per day:
Fruit intake: Yes No
Salad intake: Yes No
Frequency of eating out: Never Occasionally Frequently
Nature of oil/fat used for cooking:
Water intake per day:
Any specific questions:

I hereby understand that I am willing to pay the fee as disclosed to me for diet consultation.

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