Patient Registration

Create your DDEY Patient Account to begin your personalized lifestyle medicine and clinical reversal protocol.

Service Selection

Select the clinical program or consultation track

Consultation Service *

Your contact and demographic identification

Email *

Full Name *

Age *

WhatsApp Phone Number *

Address *

Marital Status *

Religion *

Anthropometric measurements for metabolic rate and BMI calculation

Height (meters) *e.g. 1.75 for 175cm

Weight (kg) *e.g. 85.0 kg

Chronic diagnoses, timeline, and clinical history

Current Chronic Medical Conditions *

Select all conditions currently diagnosed or under medical management:

Please specify other condition(s)

How long have you been diagnosed with this condition? *

Are you on regular (periodic) medical check-up for your condition?

Have you ever suffered a complication requiring hospitalization?

Accessibility considerations for tailored exercise and movement routines

Do you have any physical disability?

If any disability, kindly specify

Your psychological readiness for lifestyle-driven disease reversal

Are you motivated to get better via lifestyle medicine options? *

Rate your motivation from 1 (Not motivated) to 10 (Very motivated)

Level 8/10: Highly Motivated - Excellent readiness for 6-week reversing protocols.

Secure your clinical portal and confidential health history

Password *

Confirm Password *