Herbayu Wellness India Pvt Ltd

Customer Register


Wellness Greetings,
Wel-come to Herbayu Wellness India. You are requested to complete registration form. Kindly keep handy your latest health reports, Prescription if any.
Regards,
Team Herbayu
HW1000001

Package Information

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Your Personal Details

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Your Address

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Health Details

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* Case paper / Madhumeh Prashnavali

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Latest prescription by your doctor

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Latest Blood Sugar Profile : (Either a or b is mandatory )

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Latest Blood Sugar Report

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Any Other Reports(Note: If multiple reports are there kindly make pdf and then upload)

Your Password

* N.B.: The Login Password should have at least 6 characters.
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Declaration By Patient :
I . hereby declare that the particulars furnished above are true and correct to the best of my knowledge and belief. I have been given detailed information about the treatment, diet, lifestyle management and other precautions to be taken during the course of treatment. I undertake to follow all the instructions given with the treatment. If my carelessness does not bring proper or expected results or if any loss is caused in any way, then I will not blame anyone including Herbayu Wellness India Pvt. Ltd., Nature-Ved Health Care or their employees, affiliates or Swasthya Pracharak (Health Campaigner), it will all be my responsibility. At the time of treatment, it is my responsibility to give all my test reports and complete health information to my Swasthya Pracharak (Health Campaigner), and Herbayu Company from time to time. It is my responsibility to get the Herbayu products on time and to take the right amount of Herbayu products continuously till the proper results come. I am taking this treatment of my own free will.

Printing / filming of information obtained during my treatment, preparation of written and illustrated documents, use of which I give full permission without any objection and expectation to be published or disseminated for the purpose of education, research, social welfare and enlightenment.
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