Name*
Address*
Phone Number*
Email Id*
Gender* Select GenderMaleFemaleOther
Date Of Birth*
Marital Status* Select StatusMarriedUnmarried
Nationality*
Caregiver Name*
Caregiver Contact Number*
Name Of Consulting Doctor*
Doctor Phone Number
Upload Aadhar Card +
Max file size 2mb | PDF or Image File allowed to upload
Upload Invoice +
Upload Prescription +
Other information: (which may include Health information such as my medical records and history Information about my insurance coverage; Information regarding my physical, physiological and mental health; Financial information (payment/billing information); and/or process sensitive personal data like Aadhaar numbers, voters id’s or other SPDI (Sensitive Personal Data or Information) which may have been provided by me or generated by Saarathi in the course of my availing of any Services from them.)
I understand that Saarathi may use the information mentioned above to provide me with services, or use it for other purposes, some of which are: a. Registration to receive services, maintenance of my unified health profile/records, identification, communication, information on new services and offers, taking feedback, help and complaint resolution, other customer care related activities or issues relating to the use of my services. b. Creation and maintenance of electronic health records for use by Saarathi to provide relevant services. c. Receiving personalized announcements/offers from Saarathi. d. Customising suggestions for appropriate medical products and services offered by Saarathi. e. Research for the development and improvement of our products and services including our diagnostics and treatment protocols. f. Disclosure as required to government authorities in compliance with applicable law. g. Investigating, and resolving any disputes or grievances; and h. Any purpose(s) required by applicable law.
I understand that I have the right to access my personal information, and request updation, correction and deletion of such information, but not information processed in de-identified form, or any information which is retained by Saarathi to comply with applicable law.
I understand that I am free to not share any health, financial or other information that I deem confidential.
I understand that I may withdraw consent for Saarathi to use data that I have already provided to it.
I understand that if I exercise these rights, Saarathi can limit or deny the provision of services for which it considers such information necessary.
I understand that I may contactfor any questions or for exercise of these rights and for any other grievances related to my personal information. For any queries, please contact us: Toll-Free Number: 1800 267 3496 Email: amnealcare@saarathiprojects.com
Thank you, your registration is completed.