Please leave this field empty. Your FMT Journey: Consultation & Travel Details Please fill out this form to help us tailor your FMT treatment and travel plans. We’ll use your answers to make your experience as smooth and personalized as possible. If you have any questions, we’re here to help! *Age of the Patient Under 8 years8 years or older *Primary Reason for Considering FMT Please SelectAutism Spectrum Disorder (ASD)DysbiosisMultiple Sclerosis (MS)Weight Management/Weight LossIrritable Bowel Syndrome (IBS)CancerPsychiatric Conditions (e.g., BPD, GAD, Depression)Crohn's DiseaseParkinson's DiseaseUlcerative ColitisAnti-AgingAlzheimer's DiseaseOther *When would you like to begin your FMT journey? Please SelectAs soon as possible (ASAP)Within 1-3 monthsWithin 3-6 monthsIn 6 months or more *Number of FMT Sessions Desired Please SelectSingle sessionDouble sessionsMultiple sessions *Planned Duration of Stay A single session requires 3 days, including preparation: Day 1: Start a liquid diet Day 2: Take laxatives Day 3: Undergo the procedure You may complete the first two days in your home country if preferred. Please consult with our specialists for details. 3 days or more2 days1 day *Hotel and Transfer Requirements You will receive 4 complimentary transfers: Airport ↔ Hotel Hotel ↔ Hospital Select an option that fits the best Please SelectI do not require accommodation.Please recommend a hotel near the clinic.Please recommend a hotel near the city center.I need additional transfer services (please specify). Medical History Records Upload relevant medical records securely for a personalized consultation. *Medical History Please answer the following questions, or write "none" if not applicable: Allergies: Current Medications: Have you used antibiotics in the last two weeks? YesNo Have you had a recent flu or infection? YesNo Diagnosed Diseases (e.g., asthma, COPD, heart disease) If Any: Chronic Diseases If Any: Past Surgery History, If Any: Height (cm): Weight (kg): Additional Information *I will bring my own donor NoYes Is there any other information you would like to share with us? Email Country Code Phone Preferred Method of Contact: EmailPhone