TREATMENT INFORMATION REQUEST - PATIENT QUESTIONNAIRE
Please click on the image above or the link below to be redirected to the PATIENT QUESTIONNAIRE:
http://bit.ly/PATIENTQUESTIONNAIRE
Thank you for your interest in our Stem Cell Treatment Packages. By completing this form, you join the thousands of enlightened patients combating their illnesses with the greatest medicine known to man. This information allows us to evaluate your case and determine how best to improve your medical condition. You can attach additional information/documents if you like.
Treatment Package Includes:
*Patient Scheduling, Processing and Administration
*World Class Autologous Mesynchymal Bone Marrow Stem Cell Treatment consisting of Extraction, Multiplication, Differentiation, Implantation, Observation (unless other treatment protocol is indicated)
*3 Days and 3 Nights at Four Star Hotel near Treatment Center for patient AND a companion
*Local Limousine Transportation between Hotel and Treatment Facility
*Discounted airfares through our Affiliate Travel Agency
*Patients opting for a 2nd Treatment during their stay, receive the 2nd treatment at 50% off
By filling out the questionnaire, the respondent certifies that he or she is at least 18 years of age (those younger than 18 must have a parent or guardian fill out the form). Patient or guardian permits us to use the information for the analysis and evaluation of their condition for treatment at our affiliated treatment center. All Patient Questionnaire information will be treated confidentially and will only be viewed by our organization and affiliated treatment center.
