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Home
Conditions
Why SIM
How it works
Travel
Pricing
FAQ's
Contact

Home
Conditions
Why SIM
How it works
Travel
Pricing
FAQ's
Contact

Name*

Place of Birth

Date of Birth

Age

Address

Reason for Consultation

Significant Illness or Disease

When did Your Symptoms Start?

Symptoms

Treatment for Your Discomfort

Select the options you want to improve with the use of this therapy

Anti-aging

Seeks to be in the best condition

Chronic fatigue

Hormonal imbalance

Erectile dysfunction

Non-specific inflammation

Tendency to depression

Allergies - In case you have allergies to medicines, food, seasonal or skin

Yes

No

Mention that you are allergic and what happens to you

Diabetes or Pre-Diabetes

Yes

No

Date or age of diagnosis

Hipertensión - Blood pressure is too high (Greater than 130/80 mmHg)

Yes

No

Date / age of diagnosis

Heart Disease - Arrhythmia, Birth heart problems, heart muscle disease or heart valve disease

Yes

No

Name and date (Age) of diagnosis

Respiratory disease - Asthma, Bronchitis, Sleep apnea, COPD (Emphysema), Lung cancer, Lung infection (Pneumonia, Tuberculosis or COVID-19), Pulmonary edema, Pulmonary embolus

Yes

No

Name and date (Age) of diagnosis

Emboly - History of embolism (Cerebral Events)

Yes

No

Date or age of diagnosis

Thyroid Disease - Goiter, Hyperthyroidism, Hypothyroidism, Thyroid cancer, Nodules, Thyroiditis

Yes

No

Name and date (Age) of diagnosis

Kidney Disease or problems

Yes

No

Date or age of diagnosis

Liver Disease or problems - Cirrhosis, Fatty liver, Autoimmune hepatitis, Viral hepatitis

Yes

No

Name and date (Age) of diagnosis

Neurological Diseases - Headaches, Epilepsy, Multiple sclerosis, Parkinson's, Alzheimer's, Autism, Huntington's, Muscular dystrophy, Stroke sequelae

Yes

No

Name and date (Age) of diagnosis

History of fractures, accidents or chronic pain

Yes

No

Mention the antecedent and date it happened

Spinal problems (Neck or Back) - Injuries or trauma, infections, tumors, ankylosing spondylitis, scoliosis, bone changes that occur with age (spinal stenosis and/or herniated discs)

Yes

No

Mention the antecedent and date it happened

Muscle, Bone or Joint Problems - Muscular dystrophy, Neuromuscular diseases, Multiple sclerosis, Fibromyalgia, Myasthenia gravis, Myositis, Sarcoma of soft tissue, Bone cancer, Paget's disease of bone, Bone infections, Osteogenesis imperfecta, Osteonecrosis, Osteoporosis, Rickets

Yes

No

Name and date (Age) of diagnosis

Autoimmune Diseases - Systemic lupus erythematosus, Psoriasis, Vitiligo, Addison's disease, Celiac disease (gluten enteropathy), Dermatomyositis, Graves' disease, Hashimoto's thyroiditis, Multiple sclerosis, Myasthenia gravis, Pernicious anemia, Reactive arthritis, Rheumatoid arthritis, Sjögren's syndrome, Ulverative colitis

Yes

No

Name and date (Age) of diagnosis

Surgeries

Yes

No

Mention the name or type of surgery. Date (Year) or age at the time of surgery and the reason for the surgery

Medicines

Yes

No

Name the medicines, supplements, and/or vitamins you use and the time you take them

What do you expect with Stem Cell therapy?

SIM — Stemcells In Mexico

Information on this site is for educational purposes and is not medical advice. Outcomes vary. A consultation is required to determine eligibility.

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