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1. Who is the Consultation For?

2. Enter Personal Details

3.What is the condition of the current illness?

4.How accepting are you/the patient of the symptoms?

5. Are you/the patient experiencing (Select all that apply)

6. Is there little or no interest in doing things you/the patient usually enjoy?

7. Do you/the patient have trouble concentrating on things?

8. Rate the current eating habits

9. Rate your/the patient’s current physical health

10. Rate current sleeping habits

11.Who referred you to Agan Health?

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Agan Health is a psychological wellness and mental healthcare centre functioning to help children, adults, women, and the elderly suffering from psychological conditions like anxiety, depression, stress, ADHD and others to break their mental shackles and reinstate them into society.

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For appointment and consultation:

Bengaluru

BDA complex, 717/1, 16th Main, 6th B Cross Rd, above Child Central Clinic, 3rd Block, Koramangala, Bengaluru, Karnataka 560034

Trichy

#9-A, EVR Road, Aruna Nagar, Puthur, Tiruchirappalli, Tamil Nadu 620017

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