Dr. P. Banerji's Homeopathic Healthcare

Our Research

Physical face-to-face meetings with our Doctors

A Primer on Advanced Homeopathy

How the telemedicine service exactly works

Telemedicine Consultation Form

Use this form only if you are contacting us for the first time.
If you are an existing patient and are having any queries, please contact us through email or phone.
Fields marked with an asterix (*) are mandatory

Name of the Patient:*

Date of Birth (dd/mm/yy):

Age of the patient:*

Sex:* Male Female

Current Address (with country and postcode): *

Delivery Address for Sending Medicines (if different from above):

Same as above

Contact Numbers (with country and area codes) and Email Address:

Mobile:

Home Phone: *

Work Phone:

Email Address:*

Choose Your Consultation Package:

One Time Consultation
(INR 1000 / $60 USD / €50 EUR / £40 GBP)

Six months Unlimited Consultation for non-Critical Diseases
(INR 4500 / $200 USD / €150 EUR / £130 GBP)

Six months Unlimited Consultation for Critical Diseases
(INR 7500 / $375 USD / €270 EUR / £235 GBP)

One Year Unlimited Consultation for non-Critical Diseases
(INR 8000 / $385 USD / €280 EUR / £245 GBP)

One Year Unlimited Consultation for Critical Diseases
(INR 13000 / $675 USD / €490 EUR / £420 GBP)

Critical Diseases:
Cancers, Brain Tumours, Renal Failure, Heart Diseases, Brain & Spine Diseases, Cirrhosis of Liver, Infertility, Diabetes, Rheumatoid Arthritis, Female Diseases (Endometriosis, Ovarian Cysts, Uterine Fibroid), rare diseases like genetic diseases and birth defects.

Description of your Symptoms: *

Please enter a detailed description of your symptoms in the box below.
If we need more information we will contact you either on phone or email.

How did you hear about us?

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