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Welcome to Bliss Ayurveda Online Consultation* Form

 

Get our Ayurveda Expert's advise to select suitable products for yourself by filling this consultation form.

 


Fill Up and Send this Form to get our Experts Advice:

Contact Details:
Name: *
Telephone Number: *
E-mail Address: *
Street Address:
City:
Country: *
Below details will help our experts to know your Prakriti (body type).
Age: *  
Height: (eg.5 Feet 6 inch)
Weight: (eg.24 pounds or 60 kg.)
Body Frame:
Skin:
Gender:*
Appetite:* (Normal, More, Less)
Eating Habits: *

(Eating frequently / 2 or 3 meals a day,  More of junk / non vegetarian/ vegetarian food)

Habit of Coffee / Tea: (specify the quantity)
Habit of Smoking (Yes/No):* (specify the quantity)
Habit of Alcohol (Yes/No):* (specify the quantity)
Sleep:* (Specify Regular or Disturbed)
Bowel Habits:* (No. of times and consistency)
Below details will help our experts to know your Emotional / Mental Health.
Emotions:
Mind:
Memory:
Temperament:
Below details will help our experts to know your Physical Health.
Short description of Present Complaints & also specify duration of complaints:*
Supplements or Medications used for above complaint (if any):
Menstrual History in case of Women:

Please send us your details at following email address:

Email: email@blissayurveda.com 

*This consultation is just a Health & Wellness consult to help you select suitable Supplements and is not Intended to treat, diagnose or cure any disease.
Customers ordering products from outside India are suggested to order minimum quantity of 8 - 10 units of Products or Products worth 150 USD / Euro to make it financially viable in terms of Freight and Custom charges.

If you would like to have more information about our range of products please do not hesitate to contact us by e-mail or by phone, details of which are located at "Contact Us" link. We will be delighted to answer any queries you may have.


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