Travel Information: Willingness to Travel for Treatment:?* YesNo Preferred Time to Travel:?* More than 6 months3-6 months1-3 monthsWithin a month Insurance and Financial Information: Do you have health insurance that covers treatments abroad?* Yes, I have a Health InsuranceNo, I don't have a Health Insurance Are you aware of the financial requirements for the treatment?* Yes, I KnowNo, I want to know Additional Information: Any Additional Notes or Questions? Submit By submitting the form I agree to the Terms and Conditions and Privacy Policy of BMT Clinic.