Full Name (as per degree)*
Date of Birth*
Gender* MaleFemaleOther
Mobile Number (WhatsApp Enabled)*
Email ID*
Current Address*
Profile Photograph*
Degree Certificate*
University / College Name*
Year of Graduation* 2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995
Specialization OrthopaedicsNeurologySports PhysiotherapyCardio PhysiotherapyPediatric PhysiotherapyGeriatric PhysiotherapyWomen's HealthGeneral PhysiotherapyOther
Total Years of Clinical Experience* Less than 5 years5-10 years10-15 years15+ years
Aadhaar Card Number*
Aadhaar Card Photo*
PAN Card Number*
PAN Card Photo*
Account Holder Name*
Bank Name*
Account Number*
IFSC Code*
UPI ID (Optional)
Current Working Status* ClinicHospitalFreelancer
Clinic / Hospital Name
City & State of Practice*
Languages for Consultation*
Available Consultation Days* MondayTuesdayWednesdayThursdayFridaySaturdaySunday
07:00 AM08:00 AM09:00 AM10:00 AM11:00 AM12:00 PM01:00 PM
07:00 AM08:00 AM09:00 AM10:00 AM11:00 AM12:00 PM01:00 PM02:00 PM
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15:0016:0017:0018:0019:0020:0021:0022:0023:00
Expected Consultation Fees per Session (INR)*
I confirm my registration is valid and active.I agree to platform terms & teleconsultation policyI confirm I am legally eligible to practice physiotherapy in India
