Welcome to Kishansinh Demo!

The New Paradigm of Healthcare Practice.

Organization Intake Form

Kindly fill out this form to help us set up your account's Organization!
We value your privacy. This info will solely be used to create your
Kishansinh Demo business. 

Basic Details

First Name
Last Name
Phone Number
Email Address

General Question Section

Can you prepare your own meals?
Can you do your housework without help?

New Section

During the past four weeks, what was the hardest physical activity you could do for at least two minutes?
During the past four weeks, what was the hardest physical activity you could do for at least two minutes?

General Section

During the past four weeks, what was the hardest physical activity you could do for at least two minutes?
During the past four weeks, what was the hardest physical activity you could do for at least two minutes?

Thank you for taking the time!