This document contains a preliminary registration form for Finger Tip Revolution (FTR) therapy provided by the International Integrated Holistic Cure Centre (IIHCC) in Bangalore, India. The form collects the patient's contact details and medical history. It also includes a patient declaration acknowledging that FTR therapy involves the patient using their own fingertips under the guidance of an IIHCC medical consultant, with no guarantee of results. The patient agrees to a free medical consultation and for their anonymized clinical data to be used for research.