Signing form and contacts – "Ayurveda Bansko"

Please, select one of the listed four periods below:

Guests (required):

Name (required):

Phone number (required):

E-mail (required):

Comment:

Health condition

Residence (required):

Former illnesses /upon reception to the program, the client is asked to present any epicrises, blood tests, and diagnostic images available/

Current health condition /if the client is healthy or ill as well as type and progress of the disease/illness/

Clinical tests Current health condition :

To be done by the client on an empty stomach in the morning before admission to the centre.
To be presented by the client upon arrival.

CBC, general cholesterol, HDL, LDL, triglycerides, glucose, urea, creatinin, general bilirubin, general protein, uric acid;

liver enzymes: ASAT, ALAT;

urinalysis and sediment.

Contraindications for Ayurvedic treatment

Pregnancy;
Children under 12 years of age;
Women having their menstrual period.
1 month after surgery
Final stage of cancer
Condition of acute viral infection with fever (only dry compresses can be applied)
General physical weakness (treatments are held every second day).
Patients in advanced old age.

How did you learn about the program?
TVGoogleFacebookFriendE-mailNewspaper / magazineOther

We will send right back by e-mail:

What to pack list;

Health Condition Application form (if you have filled it up online, do not fill it on paper);

Information and instructions for the program

Invoice for advance payment;

Please do not forget to list the precise period of your reservation;

For any further questions do not hesitate to contact us;

Check In – after 14:00 pm, Check Out – no later than 12:00 pm;

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