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By submitting this form, you authorize Riordan Centers for Cellular Medicine to disclose your medical records to The Riordan Medical Institute in Southlake, Texas for evaluation purposes.

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Complete medical history and current condition

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Review

By clicking “Submit”:

I attest that all information I have provided on this form is accurate and complete.

I understand that inaccurate or incomplete information may result in denial of treatment.

I confirm that I have read and understand the following information:

  • The science of treatment with adult stem cells is in its infancy.
  • The treatments described on cellmedicine.com have not been evaluated by the US FDA and are not considered to be standard of care for any condition or disease.
  • There could be significant and unknown risks associated with adult stem cell treatments, as long-term studies have not been performed.
  • For most diseases no prospective, randomized clinical trials of adult stem cells have been performed, therefore no guarantee of safety or effectiveness is made or implied.
  • Treatments by licensed doctors will only be performed after the patient understands and agrees to informed consent.
  • The results of testimonials of people who appear on this website who have undergone stem cell treatment are not necessarily typical.
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  • Applications take up to 5 working days to review from the first working day they are received.
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Thank you. Our medical team will review your information and contact you within 5 business days.