Request an appointment


Complete the form below to request an appointment at AVPRF. An appointment representative will contact you within three business days to review your medical information before an appointment may be offered.


If you are having a medical emergency, Call/Whatsapp Number: +91 9790422100.




Note: All fields are required unless marked optional.

Note: The Doctors available Date and Times are as per Indian Timezone so please choose your appointment date and time accordingly.



Choose Clinic*


Choose Location*


Choose Doctor*


Choose Appointment Date*


Choose Appointment Time*



Requester Information


Who is this appointment for?*



Patient Information

Please provide patient information as it appears on legal documents.



Have you previously received care at AVPRF?*




Medical Concern


Note: After fill all the fields please click 'Add' button so that you can add more symptoms.

Diagnosis:
Symptoms:
Nature:
Location:
Aggravating factor:
Reducing factor:


Click here to see the example for how to fill?


Present Illness History:

Do you have any Past Medical Illnesses?


Do you have any Past Surgical/Treatment/Medicine History?


Life style:

Psychological State:

Family History:

Do you have any History of Drug Allergies?

Do you have any History of Other Allergies?

Are you following any Diet Pattern?

Occupation:

Do you have any Habits & Addiction?

Do you have Stress?

Are you doing any Exercise, yoga & Medication?

Do you have any Lab Investigation History?


Click here to see the example for how to fill?

Clinical Information

Please upload your clinical reports



Drop your Query (Optional)


Consultation Type



 I have read and agree to the terms of service


Important: After submission, please do not leave this form until you see the confirmation message.





Appointments by Phone

Call our representative via phone and book your appointment.

AVPRF, Ramanathapuram

Call/Whatsapp Number: +91 9790422100

9 AM to 6 PM, Monday through Saturday


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