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Medical Questionnaire

To request a free consultation and eBook, please take a few minutes to fill out this medical questionnaire. We will send you a personalized treatment plan and contact you to set up a free, no obligation consultation.

You can skip the line by calling now at 1-888-500-4673 in the US or +1-619-690-8450. Our hours are Monday-Friday 8:00 am – 6:00 PM PST, Saturdays & Sundays 9:00 am – 1:00 PM.

This information is used by our medical team to design a personalized cancer treatment plan for the patient within 48 hours