Patient must do registration for any service covered by the 'Aastha' program. Be sure to check with our representative before registration whether the medicine prescribed by your doctor is included in the 'Aastha' program.
Access the link below to register for ‘Aastha' Patient Support Program (PSP).
After accessing the link, you will first see the login and registration page with the image.
Bengali language will be provided, if you want to select English language then you can change the language by clicking here. Your profile will be created after completing all the tasks including registration. Next you can access your profile by clicking Login.
Click Register button to register online.
To download the consent form you will see the Consent Form by clicking here and the text Download will appear above the form. If you click on the Download, the form will be downloaded.
Clicking on the Register button will display you the Terms page. Read and understand the terms here.
Now (࿘) while clicking on I have read and understood the terms box, a tick mark will appear and immediately the Yes, I agree will appear.
If you agree to the terms, you can access the registration page while clicking Yes, I agree.
And if you do not agree then click on No, I do not agree.
You must fill all information in English and the information marked with star (*) must be filled.
Patient’s details will come at the beginning
1 Name of the patient: The full name of the patient should be entered here.
2 Gender: Mention whether the patient is male or female. If you are not interested to mention, click Prefer not to say.
3 Clicking on the date of birth will show a calendar. Select the patient's date of birth from the calendar. You can enter the date of birth (day/month/year) directly if you wish.
4 Enter National Identity Card Number/Passport Number.
5 Indicate email address if available.
6 Account Name will be used for login to your profile. In the Account Name field, create an account name using letters and numbers without punctuation or any other symbols. If an account with the same name already exists, another name must be selected. In that case you will be advised to set an alternate name. You can choose another name from the suggestions or by yourself.
7 The mobile number is very important for communication with you or the patient. All messages related to the program will be sent to this number, so mention the correct mobile number here.
8 Enter the same number again to confirm the mobile number.
9 There are three lines to write Address in full. The 1st line must be used. Use the next lines if needed.
10 Clicking (_) on the Categories field will show the names of all categories. Select your category.
11 After selecting the category name, clicking (_) on the District field will naturally show the names of the districts included in that category, from there select your district name.
12 If the ZIP code relevant to your address is known, mention it here.
13 If you have already purchased Roche's medicine from a distribution centre, mention the Depot ID here.
14 Mention here your ID number provided by the hospital where you are receiving treatment.
15 Here write the first three letters of your Doctor’s name in English. If more than one name is displayed, select your doctor's name and also note that the place of your treatment in the hospital related to your doctor has been selected. If you cannot find any information, please speak to our representative.
Information of the service provider
20 Mention here the name of the family/relative who is taking care of the patient all the time.
21 Mention the email address of the service provider here.
22Mention the mobile number of the service provider here.
23 Select the relationship of the service provider to the patient by clicking (_).
At least one Service box needs to be clicked here to be registered in the Aastha program.
Upload the signed Patient Consent Form by scanning or taking photo and upload it.
Then upload doctor's prescription by scanning or taking photo.
Can upload documents (TIF, TIFF, SIP, BMP, PNG, JPG, Doc, Docs, PDF, TXT, JPEG, EML or GIF) up to 10 MB.
Once full information has been provided correctly, tick mark will appear by clicking (_ I confirm that the above information is correct) box and ‘Submit’ will appear immediately. Now clicking on Submit button will submit your form online. Immediately you will see “Registration completed. Please allow 1-3 business days for our representative to verify your account” on your screen. Then clicking on Go back to login pagebutton will take you back to login and registration page with image.
If there is any error in the information, you can cancel by clicking Cancel button.
However, once you click on Submit button you cannot change any information by yourself. At this stage all information will reach our representative for verification. Our representative will contact you if any information appears to be incomplete during verification. Your registration will be completed after verification and acceptance of all information and documents. After completion of registration a message with account name and password will be sent to your mobile. You can access your account using that account name and password.
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