
 Welcome to The Mind Veda! 
 
         To effectively provide counselling services and consultation, it is important for you 
         (“Client”) to understand that the psychologist and psychiatrists of The Mind Veda 
         (“Therapist(s)”) and the Client have certain rights and responsibilities towards each other as 
         follows: 
         
| National emergency number | 112 | 
| Police | 100 | 
| Ambulance | 102 | 
| Women Helpline | 1091 | 
| Child Helpline | 1098 | 
| Senior Citizen Helpline | 1291 / 14567 | 
By signing this document, I, ______________________________________, being the Client or parent(s)/guardian(s) of the Minor, do hereby declare that I am above eighteen years of age as on the date of signing this document and mentally sound and not under any fear, threat or misconception. I have read and understood the contents of this document as well as the terms and conditions of The Mind Veda available on themindveda.com and agree to abide by them.
         Name of the Client: ______________________________________
         Mailing Address:  ________________________________________
         City:  ______________________
         State: ______________________
         Pin Code:  ____________________
         Email Id:  _________________________
         Contact No.:  ____________
         Emergency Contact (Relations):
         Signature:  _____________
         Date: ______________
      
Thank you for trusting us! You are one step closer to feeling better!
Our team will get in touch soon.