Patient Evaluation Form

Dear Patient, we thank for your interest on Stem Cell Treatment at Revita Life Sciences. To evaluate your case we need to have the following information. This will help our specialised doctors to determine and understand the medical condition that could help us in improving your quality of life. If possible, please attach previous lab studies, medical reports or any documents into an e-mail and send it to  with contact details.

The website contains no medical advice. All statements and opinions provided by the website are for educational and informational purposes. ||The treatment centres associated with Revita lifesciences provide surgical procedure only and are not involved in use or manufacture of any investigational drug ||Revita does not claim that any application or potential application, using autologous stem cells are approved by the FDA. We do not claim that these procedures work for any listed nor unlisted condition, intended or implied.||It’s important for potential patients to do their own research based on the options we present so that one can make an informed decision. Any decision to participate in experimental protocol is completely voluntary ||

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