Follow Up Questionnaire - DVC Stem

Patient Follow Up QuestionnaireForm completion time: under 5 minutes.Full nameWhich post-treatment interval are you submitting this questionnaire for?

3 month6 month9 month12 month15 month 18 month 21 month 24 month

Subjective MemoryPlease indicate your ability to recall information as of today.
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1 = poor
10 = excellentHow would you rate your memory?

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How is your memory of recent events? (today)

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How is your memory of past events? (10 years)

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Overall HealthPlease indicate a number that best identifies your response toward each statement.
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1 = poor
10 = excellentPhysical fitness

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Flexibility

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Energy level

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Balance

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Coordination

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Reaction time

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Strength

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Stamina

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Vision

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Hearing

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Libido

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Sexual function

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Quality of sleep

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Ability to concentrate

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Ability to make decisions

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Stress level

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Confidence

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Motivation

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Symptom management

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Daily pain level1 =Extreme pain
10 = No pain

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Thickness of hair

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Please explain any changes or improvements you have noticed

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DVC Stem (Da Vinci Centre)
Governors Square
23 Lime Tree Bay Ave,
Seven Mile Beach, Grand Cayman
Located Across the street from the Westin

These Terms and Conditions govern your use of the services provided by DVC Stem, the research department of the Da Vinci Centre a registered medical facility (hereinafter referred to as "DVC Stem") located in the Cayman Islands. Please read our terms & conditions carefully. By accessing or using the services of DVC Stem, you agree to comply with and be bound by these terms. DVC Stem's services strictly adhere to regulatory cGMP standards for quality along with conforming to globally recognized ISO standards that ensure safety, air purity, and processing infusions that carry human stem cells.

Our lab in the United States is designed to ensure the highest safety standards and absolute quality control for every procedure. Our mesenchymal stem cell product is manufactured in a cGMP FDA compliant facility under GMP guidelines within the United States; the study is conducted in the Cayman Islands. Disclaimer: Clinical study application of mesenchymal stem cells does not offer unequivocal guarantees and is not characterized as a cure or mainstream treatment. However, it is backed by substantial scientific support. A thorough assessment of the patient's medical history is a prerequisite to ascertain eligibility and approval for our study.

All personal information shared is strictly for internal and medical use by our healthcare providers. We are spearheading the domain of regenerative medicine by performing cutting edge IRB-approved, patient-funded clinical studies focusing on the therapeutic potential of umbilical cord tissue-derived Mesenchymal Stem Cells (MSCs). Patient reviews and testimonials featured on our site offer a glimpse of individual experiences and in no way make universal claims about the effectiveness of our study. They represent individual perceptions and may not apply to every patient.

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