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Departure Date *

I'm Flexible on the Date YesNo

Number of Nights *

Number of Adults *

Traveling with Children? YesNo

Type of Travel Luxury Panchakarma, Ayurveda & YogaMedical PanchakarmaRelax and Rejuvenate, Ayurveda & Yoga

Other Services Needed Unique ExperiencesTour GuidePost or Pre-Panchakarma StaysAirport pickup and drop

Per Person Budget for Entire Trip $7,000-$12,000 + / Above INR 6,00,000$3,000-$7,000 / Upto INR 5,80,000Less than $3,000 / INR 2,50,000Short Stay, under $1000 / INR 80,000

What are your Health Goals?

Name *

Email Address *

Phone Number *

Country of Residence *

COVID Vaccination Status Yes, fully VaccinatedPartially VaccinatedNot VaccinatedI understand the risks of traveling without vaccination

* I agree to Ayurgamaya's terms and conditions and privacy policy

Pronounced aa-yur-gah-mah-yah, my Wellness Travel Consultancy brings people of all nations to beautiful Kerala, India.

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520A Castano Corte, Los Altos CA 94020
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salila@ayurgamaya.com

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