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Telemedicine Consultation Form

Type 1 Diabetes - Adult

Please complete the following Clinical form if you wish to be treated for adult Type 1 Diabetes.

Please review the Further Details Of Throne’s Stem Cell Treatment For Autoimmunity page at this link prior to submitting your request for Telephone Consultation since it will answer many of your general questions and allow us to focus on your specific questions during that consultation information.

Clinical Form - Type 1 Diabetes - Adults

If you wish to be considered for treatment of Type 1 Diabetes in an adult with Throne’s Stem Cell Educator Therapy, please submit the following information:

Your Sex

Have You Been Diagnosed With Type 1 Diabetes?
What Were Your Symptoms When First Diagnosed?
Is There A Family History Of Type 1 Diabetes?
Do You Have Any Of These Other Autoimmune Disorders? Check All That Apply.

If You Have Recent Blood Test Results, Please Enter Them Below

Are You Employed At This Time?
Do You Have Or Need A Caretaker And, If So, Who Supplies That Care?
DISCLAIMER: I acknowledge that Throne Biotechnologies Stem Cell Educator Therapy is experimental and is NOT approved by the U.S. Food and Drug Administration for the treatment of Type 1 Diabetes or any other medical condition nor does Throne Biotechnologies claim or warrant that Stem Cell Educator Therapy is safe or effective for the treatment of Type 1 Diabetes or any other medical condition.
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