Call Consultation with a Doctor

    Application Form For Call To Doctor

    Full Name *

    Email *

    Mobile *

    Appointment Date *
    Appointment Time *
    File Upload ( Size:<3MB ) ex: pdf, docx, images

    Problem *

    I agree to terms

    ” I hereby consent to permitting the healthcare workers of Express Clinics to clinically examine me, draw or use my blood or urine samples for tests as advised by the doctors or as per my health package selected. ” By filling this appointment form, I hereby consent/ agree to receiving, in addition to test results and information related to my health, periodic updates, offers and information on promotions from Express Clinics, in a manner permitted by applicable law either by via email, SMS or voice calls.

    Enquiry Form
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    Enquiry Form