Book Therapy | Hijama Group of Mumbai

Patient Intake

Please fill out this preliminary intake form. Our clinical coordinator will contact you to confirm a time slot.

Mumbai Clinic

Mumbai, Maharashtra, India

Direct Line

+91 00000 00000

Note: Fasting for 3-4 hours prior to Hijama is strictly required.

Appointment Request Form

Patient Full Name *

Age / Gender *

Mobile Number (WhatsApp) *

Email Address

Therapy Required *

Current Medical Conditions (Optional but recommended)

Medical & Communication Consent: I confirm that the information provided is accurate. I explicitly consent to receive therapy updates, appointment confirmations, and health advisories via SMS, WhatsApp, or phone calls from Hijama Group of Mumbai, in accordance with the Privacy Policy.