DVC Stem logo

Treatment Application

Please complete this brief online application to find out if you are a candidate for our IRB-approved stem cell protocol located in Grand Cayman.

It is highly recommended that you review our FAQ Page before continuing.

Globe svg
Secure HIPAA Compliant Form.
email svg
Response within 24 hours.
No Obligations.
Scroll down to begin.
dvc stem logo

1

Initial Screening

The initial screening form will allow us to determine if you are a good candidate to begin the pre-treatment process. Most applications will receive a response within 24 hours.

Intake Forms

If accepted you will receive a link to complete your medical history forms. Once completed you will receive a list of labs / exams that must be completed prior to treatment.

2

Packet Review

Once your forms, medical history, and labs / exams have been submitted for review, our medical team may provide final clearance.

3

Schedule Treatment

Once approved, you may book your treatment on your desired date, subject to availability.

4

It is highly recommended that patients review our FAQ Page before continuing.

Please answer the following screening questions to determine if you are a candidate to begin the pre-treatment process for our stem cell program.

COVID-19 Update: Our ports of entry are currently closed for international travel. We are still accepting patient applications for future treatment dates, and our medical team is still processing incoming patient pre-treatment packages. Once a patient has completed their pre-treatment requirements, they will be put on a contact list to schedule a treatment date at earliest availability.

Form completion time: under 3 minutes.

Step 1
1 / 12
This is a patient-funded program

I understand that this is a patient-funded program and treatment cost starts at $20,000 USD. Travel and accommodation are not included. (Financing available for US residents)

Step 2
2 / 12
Please acknowledge the above statement in order to continue.
Next
Please select at least one option.
Capable of international travel?

DVC Stem is located in Grand Cayman. Candidate must be physically, mentally and legally able to travel internationally to our clinic for treatment.

Step 3
3 / 12
Our clinic is located in Grand Cayman. Patient must be able to travel internationally.
Next
Please select at least one option.
Pregnant?

Is the candidate pregnant or at risk of being so?

Step 4
4 / 12
Please select at least one option.
Taking immunosuppressives?

This includes but not limited to: Calcineurin Inhibitors: Tacrolimus and Cyclosporine Antiproliferative agents: Mycophenolate Mofetil, Mycophenolate Sodium and Azathioprine

Step 5
5 / 12
Please select at least one option.
Cancer diagnosis?

Is candidate currently diagnosed with any type of cancer?

Step 6
6 / 12
Any active cancers will disqualify patient for treatment.
Next
Please select at least one option.
Active or chronic viral infection?

This includes HIV1, HIV2, Hepatitis B or Hepatitis C.

Step 7
7 / 12
Please select at least one option.
Current medical condition

We specialize in treatments for Autoimmune conditions & Chronic Inflammation.  We do not provide localized site injections.

Medical Condition (required)
Current Diagnosis
Step 8
8 / 12
Please complete the fields above.
Medical history

Please describe your current symptoms and medical history. Providing detailed information will help speed up the application proccess.

Current symptoms / medical history
Step 9
9 / 12
Please complete the field above.
Treatment goals

Please include a brief description of what you hope to achieve with treatment. This will help our medical team better understand your unique goals.

What are your treatment goals?
Step 10
10 / 12
Please complete the field above.
Candidate information

Please include full name, age and gender.

Gender
Step 11
11 / 12
Please complete all fields above.
Contact information

Thanks for taking the time to complete this application. There are no obligations associated with completing this application.

Final Step
12 / 12
Email Address

Success!

Thank you! Your submission has been received!

Our Medical Director will review your application within 24 hours and respond with either an approval to continue or a request for further information.

If you are approved you will be provided an email response with directions on how to proceed with the patient onboarding process.

Please add info@dvcstem.com to your contacts list to ensure you receive a response. Please check your junk / spam folder if you do not receive a response.

Learn more about our IRB-approved treatment protocol here →

Oops! Something went wrong while submitting the form