PCOS Club India

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Step 1/4

Personal Details

Salutation*

Full Name*

Gender*

Email *

Contact/ Phone number*

Date of Birth

Education[ Degree and Certifications]*

Language Preference*

Country

State

City

About me*

What is your Mantra to treat your PCOS patients? What is the first-hand treatment you include to treat PCOS? eg-providing supplements, prescribing birthcontrols*

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Step 2/4

Professional Details

Type*

Speciality*

Niche*

Your Hospital Name*

Your Hospital Address*

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Your Clinic Name (If Available)

Your Clinic Number (If Available)

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Professional Active Memberships

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Step 3/4

Services & Charges

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Service Name*

Duration (Month)*

No. of Sessions (Per Month)

Charge*

Delete

I provide free intro call

Do you include counselling in your sessions?

Yes

Do you include counselling or onboarding guidance before enrolling your customer?

Yes

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Step 4/4

Other Details

Any other Ideas/comments you want to share?*

Any recommendations that you'd like to provide us in the category of gynecologists', endocrinologist, fitness professionals for PCO*

Do you already have specific Nutritionist or Fitness Expert you want to recommend? If yes please add name and contact information*

Instagram handle/website links*

Is there any specific supplement brands that you will recommend to our patients? If yes, please specify*

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