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MEDICAL QUESTIONNAIRE
Print this page and fax it with your medical records for complete confidentiality and security of privacy
 
 
  • ADULT STEM CELLS are the natural healing device in the human body.
  • ADULT STEM CELL derived treatments are some of the greatest therapies know to modern medicine.
  • ADULT STEM CELLS have all of the benefits and none of the side effects or controversy of    embryonic stem cells
 
There is only one problem
ADULT STEM CELLS ARE NOT AVAILABLE TO PATIENTS IN THE USA!

ADULT STEM CELLS have allowed patients outside the USA to reap huge rewards of life extension and improved quality of life. In many cases, 60-70% of patients experience RECOVERY from so-called incurable diseases like Autism, Multiple Sclerosis, Spinal Cord Injury, Optic Nerve Diseases, Diabetes, Heart Disease and many others.Millions of patients are struggling with diseases and the treatment options available to them are not helping them. Perhaps you have a friend or loved one with an incurable or debilitating disease. 
CLIENT CONTACT EVALUATION QUESTIONS
YOUR FULL NAME
YOUR CONTACT PHONE #( OF INQUIRER)
YOUR EMAIL ADDRESS
Relationship to Patient?
PATIENT'S FULL NAME
GENDER OF PATIENT
COUNTRY OF RESIDENCE
What are the symptoms of the condition that you have?
What Treatment Proceedures are you interested in obtaining?
What treatments or surgeries have you had to date due to your condition?
What activities of daily life (walking, breathing, getting into bed, cooking, eating, etc.) do you have trouble with?
What other complications do you have?
What prescripitons do you take currently?
What is your mental condition as a result of this condition?
What questions do you have about stem cell therapy or our services?
ANY ADDITIONAL QUESTIONS OR CONCERNS?
It's completely up to you!         Fax your personal information to us with printed questionnaire completed. 
 
FAX # is   888 -512 -5390                 
 
Our company is based on the belief that our customers' needs are of the utmost importance. Our entire team is committed to meeting those needs. As a result, a high percentage of our business is from  satisfied customers giving us referrals.
 
We welcome the opportunity to earn your trust and deliver you the best service in the health industry.  We endorse only the world's leading Stem Cell Physicians with the highest integrity, experience, and results. Never Embryonic Stem Cells.  Only Adult Stem Cells!
 
Let us put you on the best path to reclaim your Health & Well being by connecting you with the top Stem Cell Regenerative Medicine Clinic,  and World Leading Medical recognized Physician experts.
 
 
We deliver the best Treatment Clinic and Physician for You....... and include  a Vacation 3 day 3 night Hotel Package for YOU and a Companion at a Four Star Facility near your  treatment center.
 
We have arranged discounts when you purchase your flight needs through our special arrangement with Fare Buzz of New York, NY.
We can and do arrange everything for you.    You, the Clinic, and your Attending Physician, are in total control and communication coordinated by us prior to scheduling your  treatment and when you return home.
 
Please contact or e-mail us for complete details specific to you, in order for us  to help you plan and make the best life decision possible!  Fees to schedule your treatment are outlined in " OUR Client Program" web page #4 herein.
 
 Location:
'RMTTP'  WORLD CORPORATE HEADQUARTERS
1103 Douglas Avenue
Dunedin, Florida - USA  34698
 
 
Hours:                       24/7  CALL TOLL FREE 
Best Adult stem cell treatments offered by the Best Doctor's in the world . Mon - Fri: 9AM - 5PM              (888) 551-5398 
Sat: 10AM - 5PM                  Fax #  888 - 512 -5390
Sun: Closed    
 
 
  " You are not alone anymore!
   We are here to help