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Art of Cleansing
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Immune Resilience Retreat
Natural Relaxation Retreat
Optimal Weight Retreat
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Garden-View Rooms
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Fishing for Weal
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Book Now
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Tariff
Reservation Form
Menu
Home
Our Approach
Open menu
Ayurveda
Nature Cure
Healing through yoga
Physiotherapy
Animal Assisted Therapies
Family Wellness
Wellness Programs
Open menu
Art of Cleansing
Healthy Natural Living
Immune Resilience Retreat
Natural Relaxation Retreat
Optimal Weight Retreat
Living Spaces
Open menu
Garden-View Rooms
Lake-View Suites
Experiences
Open menu
Nature Trails
Self-Discovery with Horses
Fishing for Weal
The Art of Birding
Artisanal Cheesemaking
Facilities
Contact Us
Book Now
Open menu
Tariff
Reservation Form
Reservation Form
Name of Guest
Mr
Mrs
Ms
Dr
Date of Birth
Age
Gender
Marital status
Nationality
Occupation
Height (in Cms)
Weight (in Kgs)
Contact number
Email
Address
Health / Disease Condition
Purpose of Visit (Select applicable):
Relaxation retreat
Detox retreat
Immunity boosting retreat
Weight management retreat
Lifestyle management retreat
Have you undergone any surgery in recent years
Yes
No
If yes, please give details
Do you suffer from any kind of infectious disease or skin disease
Yes
No
If yes, please give details
Do you suffer from any heart disease or undergone angioplasty / bypass / open-heart surgery in the past
Yes
No
If yes, please give details
Do you suffer from any type of Kidney / Liver / Lung disease
Yes
No
If yes, please give details
Are you physically or visually disabled in anyway
Yes
No
If yes, please give details
Can you walk 1 km without support
Yes
No
If no, please give details
Details of addiction if any (Select all applicable):
Smoking
Alcohol
Zarda
Pan Masala
Tea
Coffee
Medication
Drug Addiction
How did you get to know of Fazlani Natures Nest?
Friends/Family
Website
Social Media
Please attach a copy of your health reports and list of medicines in case you are suffering from any serious health issues. Upon approval from our medical team your admission will be confirmed.
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