Register Now Clinical Sessions Please enable JavaScript in your browser to complete this form.Name *FirstLastDOB (dd/mm/yyyy) *Age *Address *Email *Phone Number *What kind of session would you prefer ? *In PersonOnline SessionPlease indicate the course(s) you are interested inCounseling for senior citizens / Geriatric CounselingTeenage CounselingMarriage and Family CounselingRehabilitation CounselingMental Health CounselingCounseling for de-addictionArt therapyPlay therapyCognitive behavior therapyOtherWhat would you like to Book ? *Single Session (₹ 2500)Six Session Package (₹ 12000)Basic Course Module (₹ 25000)Tell us more about yourself *Number of family membersHealth issues *Please use "Not Applicable" if the answer is not relevantAre you undergoing any treatment *Please use "Not Applicable" if the answer is not relevantName of the doctorMedication if anyPlease use "Not Applicable" if the answer is not relevantWhere did you hear about us ?Who referred you ?Submit