Your assessment has been received! One of our team members will contact you to schedule an appointment. if you have any questions, please give us a call at 407-412-5030.
Please add the following questions
- 1) What is your name?
- 2) On a scale of 1 to 5, how painful is your knee pain?
-
- a – No pain
- b – A little annoyng pain
- c – nagging and uncomfortable pain
- d – intense and miserable pain
- e – Worst possible, unbearable, excruciating pain
- 3) In two or three sentences, please tell us what makes you a good candidate for Stem Cell Therapy?
- 4) How serious are you about finding a solution to your knee pain?
-
- a – Just searching nad looking ofr options
- b – very interested and looking at 3nd opinion
- c – very serious – i am getting treatment in the next 6o days.
- d – other
- 5) Our Stem Cell Therapy options range up to $5000. What best describes your ability to pay for stem cell therapy?
-
- a – I am aware of the cost but can’t pay for them right now.
- b – I can pay the full amount up front
- c – I would consider a payment plan if the Stem Cell Therapy is right for me.
- 6) Do you have medical insurance
-
- a – I have medical insurance
- b – I have medicaid / medicare
- c – I dont have medical insurance
- 7) what is the best way to reach you?
-
- a – phone
- b – email
- 8) what is the best number to reach you?
- 9) What is teh best tim e to reach you?
-
- a – morning
- b – Mid-day afternoon
- c – Evening
- 10) upon receiving your application, we will contact you to schedule a date and time for your consultation. Do you commit to making your appoinment?
-
- a – Yes, I commit to showing up for my scheduled consultation.
- b – other.