Welcome to BioGenesis Regenerative Center
Please fill out the form below for our Stem Cell Therapy, and we’ll contact you soon with updates and to schedule your appointment.
Treatment Cost
I understand that this is a patient-funded therapy and treatment cost is minimum $10,000 USD. (Travel and accommodation are not included).
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No
Yes
Capable of international travel?
BioGenesis is situated in Panama City, Panama. Candidates must be physically, mentally, and legally capable of traveling to our clinic for treatment. If you have mobility challenges, please ensure you travel with a companion.
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Yes
No
Pregnant?
Is the patient currently pregnant or at risk of pregnancy?
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Yes
No
Cancer Diagnosis?
Is candidate currently diagnosed with any type of cancer?
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Yes
No
Active Viral Infection
This includes HIV-1, HIV-2, Hepatitis B, and Hepatitis C. We cannot accept patients with active viral infections.
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Yes
No
Diagnosis
Please select the medical condition that best describes your case below.
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Please Select
Alzheimer
COPD
Muscle Recovery
Multiple Sclerosis
Anti Aging
Diabetes
Kidney Disease
Lupus
Erectile Dysfunction
Liver Disease
Heart Disease
Rheumatoid Arthritis
Osteoarthritis
Current Diagnosis (additional information)
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Current Symptoms
Please describe your current symptoms and medical history in detail, as this will help expedite the application process.
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Treatment Goals
Please provide a brief description of your treatment goals, as this will help our medical team understand your unique needs.
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Ej: reduction in pain, improved energy, etc
Candidate Information
Full Name
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First Name
Last Name
Date of Birth
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Month
/
Day
Year
Date
Gender
*
Please Select
Male
Female
N/A
Contact Information
Please enter your email address below so our team can respond to your application. Completing this form carries no obligations.
Email
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example@example.com
How did you hear from us? (optional)
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Google
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Recomendation
Other
Please verify that you are human
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