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Subscribe to MAYA
 
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( Please give details of the person availing the service within India )
Name* A value is required.
Surname* A value is required.
Date Of Birth (dd-mm-yy) Invalid format.
Gender
Marital status
If married  
Spouse' date of birth (dd-mm-yy) Invalid format.
Wedding anniversary (dd-mm-yy) Invalid format.
Home phone( Please include STD code ) * A value is required.Invalid format.
Mobile phone( Please include ISD and STD code ) * A value is required.Invalid format.
E-mail Invalid format.
Detailed address where the service is to be provided (min 75 characters) *   A value is required.Minimum number of characters not met.
Nearest landmark
City
Pincode
Alternate contact within India  (To be contacted in times of emergency or if recipient is not reachable on phone)
Name
Phone( Please include ISD and STD code )
Sponsor details (Sponsor is the person buying the service)
Name* A value is required.
Surname* A value is required.
Gender
Sponsor's designation
Relation with family member availing the service in India
E-mail* A value is required.Invalid format.
Phone( Please include ISD and STD code ) * A value is required.Invalid format.
Sponsor's current location
Special instructions to Maya CARE during their interactions with your family
Maya CARE Subscription options:
You can request for multiple services in a single Maya CARE visit. For instance, keep couple of cheques/bills to be paid/shopping list ready and also ask the Maya CARE service associate to read to the senior citizen/take up physiotherapy exercises or accompany to the doctor.
Option 1: Rs 250/- Maya CARE membership - entitles you to a Maya CARE membership card and one 1.5 hour visit by the Maya CARE associate). The visit can be availed within 6 months. Subsequent Maya CARE visits at Rs 200/- per 1.5 hours.
Option 2: Rs 1000/- entitles you to request five visits of 1.5 hours each to be availed within 6 months.
Option 3: Rs 1600/- per month entitles you to two vists of 1.5 hours per week.
Option 4: Rs 2400/- per month entitles you to three visits of 1.5 hours per week. 
Option 5: Premium services of longer duration are charged in units of Rs 200/- per 1.5 hours. For instance, Rs 400/- for 3 hours, Rs 600 for 4.5 hours

I accept Terms and Conditions. Please make a selection.