Dietician Registration

Cordia® Sense Dietician

Full Name *

Phone Number *

Email *

Gender *

Male

Female

Other

Permanent Address *

Country *

State *

City *

Pincode *

Establishment Details *

I own an establishment

I visit an establishment

Establishment Name *

Establishment Address *

Educational Qualifications with Year of Completion (e.g. MBBS in 2005) *

Are you a registered Dietician? *

Yes

No

Area of Specialisation *

Years of Experience (e.g. 2) *

What services would you like to offer via Cordia® Platform? *

Diabetes Management

Hypertension Management

Obesity Management

Maternity Care

Identity Proof & Profile Picture - Please upload your Profile Picture and Aadhar Card/Driving License/Any Other Govt. ID *

Click to upload

Upload files0/5 files

How many patients do you intend to counsel using Cordia® platform in a month? *

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