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To your patient packet
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Patient Information
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Medical History
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Emergency Contact
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Eligibility Criteria
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Vitality
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Consent Form
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Final Submission
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Forms
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Lab work
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Submission
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Patient Packet Instructions

Thank you for choosing DVC Stem.

Please fill out the information and consent form located below. Once completed, you will receive a list of labs that must be submitted prior to receiving final treatment clearance.

If you require assistance or have any questions please do not hesitate to call our support team or email info@dvcstem.com.

Patient Disclaimer

Any patient health information (PHI) provided will be transmitted to DVC Stem electronically and held on an encrypted, HIPAA-compliant server. This transmission is intended for the sole use of the individual or entity to whom it is addressed. By submitting this form, patients are agreeing to the use of electronic communications for any information provided by the patient, and in accordance with our privacy policy. Your information will NOT be shared with any third parties.

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Efficient support via email

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Patient logistics questions?

Have any questions related to treatment or travel logistics? Get in contact with our concierge team