immunotherapyinstitute.com
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2606:4700:3037::ac43:d6a9
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URL:
https://immunotherapyinstitute.com/
Submission: On January 01 via api from US — Scanned from DE
Submission: On January 01 via api from US — Scanned from DE
Form analysis
4 forms found in the DOMGET https://immunotherapyinstitute.com/
<form role="search" action="https://immunotherapyinstitute.com/" method="GET">
<input type="text" name="s" value="" aria-label="Search" placeholder="Search">
<span>Hit enter to search or ESC to close</span>
</form>
POST /#gf_1
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_1" id="gform_1" class="itc-lead-form itc-lead-form--content" action="/#gf_1" data-formid="1" novalidate="">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform-body gform_body">
<ul id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_1_7" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_7"><label
class="gfield_label gform-field-label" for="input_1_7">Your First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_7" id="input_1_7" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_11" class="gfield gfield--type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_11"><label
class="gfield_label gform-field-label" for="input_1_11">Your Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_1_11" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_6" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_6"><label
class="gfield_label gform-field-label" for="input_1_6">Relationship to Patient<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select">
<div class="fancy-select-wrap"><select name="input_6" id="input_1_6" class="large gfield_select select2-hidden-accessible" aria-required="true" aria-invalid="false" tabindex="-1" aria-hidden="true">
<option value="" selected="selected" class="gf_placeholder">Choose One:</option>
<option value="Myself" selected="selected">Myself</option>
<option value="Spouse">Spouse</option>
<option value="Family Member">Family Member</option>
<option value="Friend">Friend</option>
<option value="Other">Other</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true"
aria-expanded="false" tabindex="0" aria-labelledby="select2-input_1_6-container"><span class="select2-selection__rendered" id="select2-input_1_6-container" title="Myself">Myself</span><span class="select2-selection__arrow"
role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span></div>
</div>
</li>
<li id="field_1_12" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_12" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_1_12">Patient First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_12" id="input_1_12" type="text" value="" class="large" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_1_13" class="gfield gfield--type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_13"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_1_13">Patient Last Name<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_13" id="input_1_13" type="text" value="" class="large" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_1_2" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_2"><label class="gfield_label gform-field-label"
for="input_1_2">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_2" id="input_1_2" type="email" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_1_9" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_9"><label
class="gfield_label gform-field-label" for="input_1_9">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_1_9" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_18" class="gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_18"><label class="gfield_label gform-field-label"
for="input_1_18">Cell Phone</label>
<div class="ginput_container ginput_container_text"><input name="input_18" id="input_1_18" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_1_10" class="gfield gfield--type-select gf_left_half sel-country gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_10"><label
class="gfield_label gform-field-label" for="input_1_10">Country<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select">
<div class="fancy-select-wrap"><select name="input_10" id="input_1_10" class="medium gfield_select select2-hidden-accessible" aria-required="true" aria-invalid="false" tabindex="-1" aria-hidden="true" style="display: none;">
<option value="" selected="selected" class="gf_placeholder">Choose One:</option>
<option value="United States">United States</option>
<option value="Canada">Canada</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Brazil">Brazil</option>
<option value="Brunei">Brunei</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo, Democratic Republic of the">Congo, Democratic Republic of the</option>
<option value="Congo, Republic of the">Congo, Republic of the</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="East Timor">East Timor</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Polynesia">French Polynesia</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="North Korea">North Korea</option>
<option value="South Korea">South Korea</option>
<option value="Kosovo">Kosovo</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos">Laos</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macedonia">Macedonia</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia">Micronesia</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine, State of">Palestine, State of</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russia">Russia</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten">Sint Maarten</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Sudan, South">Sudan, South</option>
<option value="Suriname">Suriname</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="Togo">Togo</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican City">Vatican City</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Vietnam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_1_10_chosen" style="width: 1px;"><a class="chosen-single">
<span>Choose One:</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off" tabindex="-1">
</div>
<ul class="chosen-results"></ul>
</div>
</div><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true"
aria-expanded="false" tabindex="0" aria-labelledby="select2-input_1_10-container"><span class="select2-selection__rendered" id="select2-input_1_10-container" title="Choose One:">Choose One:</span><span
class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
</div>
</li>
<li id="field_1_4" class="gfield gfield--type-select gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_4"><label
class="gfield_label gform-field-label" for="input_1_4">Cancer/Disease Type<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select">
<div class="fancy-select-wrap"><select name="input_4" id="input_1_4" class="large gfield_select select2-hidden-accessible" aria-required="true" aria-invalid="false" tabindex="-1" aria-hidden="true" style="display: none;">
<option value="" selected="selected" class="gf_placeholder">Choose One:</option>
<option value="Adenocarcinoma">Adenocarcinoma</option>
<option value="Adrenal Cancer">Adrenal Cancer</option>
<option value="Anal Cancer">Anal Cancer</option>
<option value="Appendix Cancer">Appendix Cancer</option>
<option value="Bile Duct Cancer">Bile Duct Cancer</option>
<option value="Bladder Cancer">Bladder Cancer</option>
<option value="Bone Cancer">Bone Cancer</option>
<option value="Brain Cancer">Brain Cancer</option>
<option value="Breast Cancer">Breast Cancer</option>
<option value="Carcinoid Tumors">Carcinoid Tumors</option>
<option value="Cervical Cancer">Cervical Cancer</option>
<option value="Colorectal Cancer">Colorectal Cancer</option>
<option value="Endometrial Cancer">Endometrial Cancer</option>
<option value="Esophageal Cancer">Esophageal Cancer</option>
<option value="Eye Cancer">Eye Cancer</option>
<option value="Gallbladder Cancer">Gallbladder Cancer</option>
<option value="Gastrointestinal Stromal Tumors">Gastrointestinal Stromal Tumors</option>
<option value="Head & Neck Cancer">Head & Neck Cancer</option>
<option value="Hodgkin Lymphoma">Hodgkin Lymphoma</option>
<option value="Intestinal Cancer">Intestinal Cancer</option>
<option value="Kidney Cancer">Kidney Cancer</option>
<option value="Leukemia">Leukemia</option>
<option value="Liver Cancer">Liver Cancer</option>
<option value="Lung Cancer">Lung Cancer</option>
<option value="Lymphoma">Lymphoma</option>
<option value="Melanoma">Melanoma</option>
<option value="Mesothelioma">Mesothelioma</option>
<option value="Metastatic Squamous Neck Cancer">Metastatic Squamous Neck Cancer</option>
<option value="Multiple Myeloma">Multiple Myeloma</option>
<option value="Neuroblastoma">Neuroblastoma</option>
<option value="Non-Hodgkin Lymphoma">Non-Hodgkin Lymphoma</option>
<option value="Oral Cancer">Oral Cancer</option>
<option value="Ovarian Cancer">Ovarian Cancer</option>
<option value="Pancreatic Cancer">Pancreatic Cancer</option>
<option value="Penile Cancer">Penile Cancer</option>
<option value="Primary Central Nervous System (CNS) Lymphoma">Primary Central Nervous System (CNS) Lymphoma</option>
<option value="Prostate Cancer">Prostate Cancer</option>
<option value="Sarcoma">Sarcoma</option>
<option value="Sinus Cancer">Sinus Cancer</option>
<option value="Skin Cancer">Skin Cancer</option>
<option value="Small Intestine Cancer">Small Intestine Cancer</option>
<option value="Spinal Cancer">Spinal Cancer</option>
<option value="Squamous Cell Carcinoma">Squamous Cell Carcinoma</option>
<option value="Stomach Cancer">Stomach Cancer</option>
<option value="Testicular Cancer">Testicular Cancer</option>
<option value="Throat Cancer">Throat Cancer</option>
<option value="Thymoma / Thymic Carcinoma">Thymoma / Thymic Carcinoma</option>
<option value="Thyroid Cancer">Thyroid Cancer</option>
<option value="Urethral Cancer">Urethral Cancer</option>
<option value="Uterine Cancer">Uterine Cancer</option>
<option value="Vaginal Cancer">Vaginal Cancer</option>
<option value="Vulvar Cancer">Vulvar Cancer</option>
<option value="Other">Other</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_1_4_chosen" style="width: 1px;"><a class="chosen-single">
<span>Choose One:</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off" tabindex="-1">
</div>
<ul class="chosen-results"></ul>
</div>
</div><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true"
aria-expanded="false" tabindex="0" aria-labelledby="select2-input_1_4-container"><span class="select2-selection__rendered" id="select2-input_1_4-container" title="Choose One:">Choose One:</span><span class="select2-selection__arrow"
role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
</div>
</li>
<li id="field_1_31" class="gfield gfield--type-captcha field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_31"><label class="gfield_label gform-field-label"
for="input_1_31">CAPTCHA</label>
<div id="input_1_31" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Lds5aggAAAAAO5pgHqKdL5xH9ZKLliE8Scfyuos" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-v7wl2celwwmh" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lds5aggAAAAAO5pgHqKdL5xH9ZKLliE8Scfyuos&co=aHR0cHM6Ly9pbW11bm90aGVyYXB5aW5zdGl0dXRlLmNvbTo0NDM.&hl=en&v=u-xcq3POCWFlCr3x8_IPxgPu&theme=light&size=normal&cb=z8ikucssqslg"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</li>
<li id="field_1_20" class="gfield gfield--type-checkbox gfield--type-choice gf_right_half hide-field-label field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden" data-js-reload="field_1_20">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label screen-reader-text gfield_label_before_complex"></label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_1_20">
<li class="gchoice gchoice_1_20_1">
<input class="gfield-choice-input" name="input_20.1" type="checkbox" value="Yes, mail me an info packet" id="choice_1_20_1">
<label for="choice_1_20_1" id="label_1_20_1" class="gform-field-label gform-field-label--type-inline">Yes, mail me an info packet</label>
</li>
</ul>
</div>
</li>
<li id="field_1_15" class="gfield gfield--type-checkbox gfield--type-choice gf_right_half hide-field-label field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_15"><label
class="gfield_label gform-field-label screen-reader-text gfield_label_before_complex"></label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_1_15">
<li class="gchoice gchoice_1_15_1">
<input class="gfield-choice-input" name="input_15.1" type="checkbox" value="additional-comments" id="choice_1_15_1">
<label for="choice_1_15_1" id="label_1_15_1" class="gform-field-label gform-field-label--type-inline">Add Additional Comments</label>
</li>
</ul>
</div>
</li>
<li id="field_1_21" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_21" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_1_21">Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_21" id="input_1_21" type="text" value="" class="large" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_1_23" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_23" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_1_23">State / Province</label>
<div class="ginput_container ginput_container_text"><input name="input_23" id="input_1_23" type="text" value="" class="large" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_1_24" class="gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_24" data-conditional-logic="hidden" style="display: none;">
<label class="gfield_label gform-field-label" for="input_1_24">City</label>
<div class="ginput_container ginput_container_text"><input name="input_24" id="input_1_24" type="text" value="" class="medium" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_1_25" class="gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_25" data-conditional-logic="hidden" style="display: none;">
<label class="gfield_label gform-field-label" for="input_1_25">Zip / Postal Code</label>
<div class="ginput_container ginput_container_text"><input name="input_25" id="input_1_25" type="text" value="" class="medium" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_1_14" class="gfield gfield--type-textarea additional-comments field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_14" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_1_14">Additional Comments</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_14" id="input_1_14" class="textarea small" aria-invalid="false" rows="10" cols="50" disabled="disabled"></textarea></div>
</li>
<li id="field_1_27" class="gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_27">
<div class="ginput_container ginput_container_text"><input name="input_27" id="input_1_27" type="hidden" class="gform_hidden" aria-invalid="false" value="https://immunotherapyinstitute.com/ - Home"></div>
</li>
<li id="field_1_30" class="gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_30">
<div class="ginput_container ginput_container_text"><input name="input_30" id="input_1_30" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</li>
<li id="field_1_28" class="gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_28">
<div class="ginput_container ginput_container_text"><input name="input_28" id="input_1_28" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</li>
<li id="field_1_29" class="gfield gfield--type-uid field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden" data-js-reload="field_1_29"><label class="gfield_label gform-field-label" for="input_1_29">ITI Form
ID</label>
<div class="ginput_container ginput_container_hidden"><input name="input_29" id="input_1_29" type="hidden" value=""></div>
</li>
<li id="field_1_999999" class="gfield gfield--type-text honeypot-field field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_999999"><label class="gfield_label gform-field-label"
for="input_1_999999">Contact Fax</label>
<div class="ginput_container ginput_container_text"><input name="input_999999" id="input_1_999999" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_1_1000000" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_1_1000000"><label
class="gfield_label gform-field-label" for="input_1_1000000">Name</label>
<div class="ginput_container"><input name="input_1000000" id="input_1_1000000" type="text" value="" autocomplete="new-password"></div>
<div class="gfield_description" id="gfield_description_1_1000000">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_1" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} jQuery("#gform_1").trigger("submit",[true]); }">
<input type="hidden" name="gform_ajax" value="form_id=1&title=1&description=&tabindex=0&theme=data-form-theme='legacy'">
<input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="1">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsIjdmNWZhZTVmZGNlNDRlY2QxMDE1Njc0YWZjZWI2OGIwIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
<p style="display: none !important;"><label>Δ<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_1" name="ak_js" value="1704151890765">
<script>
document.getElementById("ak_js_1").setAttribute("value", (new Date()).getTime());
</script>
</p>
</form>
POST /
<form method="post" enctype="multipart/form-data" id="gform_1" class="itc-lead-form itc-lead-form--content" action="/" data-formid="1" novalidate="">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform-body gform_body">
<ul id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_1_7" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_7"><label
class="gfield_label gform-field-label" for="input_1_7">Your First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_7" id="input_1_7" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_11" class="gfield gfield--type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_11"><label
class="gfield_label gform-field-label" for="input_1_11">Your Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_1_11" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_6" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_6"><label
class="gfield_label gform-field-label" for="input_1_6">Relationship to Patient<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select">
<div class="fancy-select-wrap"><select name="input_6" id="input_1_6" class="large gfield_select select2-hidden-accessible" aria-required="true" aria-invalid="false" tabindex="-1" aria-hidden="true">
<option value="" selected="selected" class="gf_placeholder">Choose One:</option>
<option value="Myself" selected="selected">Myself</option>
<option value="Spouse">Spouse</option>
<option value="Family Member">Family Member</option>
<option value="Friend">Friend</option>
<option value="Other">Other</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true"
aria-expanded="false" tabindex="0" aria-labelledby="select2-input_1_6-container"><span class="select2-selection__rendered" id="select2-input_1_6-container" title="Myself">Myself</span><span class="select2-selection__arrow"
role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span></div>
</div>
</li>
<li id="field_1_12" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_12"><label
class="gfield_label gform-field-label" for="input_1_12">Patient First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_12" id="input_1_12" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_13" class="gfield gfield--type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_13"><label
class="gfield_label gform-field-label" for="input_1_13">Patient Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_13" id="input_1_13" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_2" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_2"><label class="gfield_label gform-field-label"
for="input_1_2">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_2" id="input_1_2" type="email" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_1_9" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_9"><label
class="gfield_label gform-field-label" for="input_1_9">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_1_9" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_18" class="gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_18"><label class="gfield_label gform-field-label"
for="input_1_18">Cell Phone</label>
<div class="ginput_container ginput_container_text"><input name="input_18" id="input_1_18" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_1_10" class="gfield gfield--type-select gf_left_half sel-country gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_10"><label
class="gfield_label gform-field-label" for="input_1_10">Country<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select">
<div class="fancy-select-wrap"><select name="input_10" id="input_1_10" class="medium gfield_select select2-hidden-accessible" aria-required="true" aria-invalid="false" tabindex="-1" aria-hidden="true">
<option value="" selected="selected" class="gf_placeholder">Choose One:</option>
<option value="United States">United States</option>
<option value="Canada">Canada</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Brazil">Brazil</option>
<option value="Brunei">Brunei</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo, Democratic Republic of the">Congo, Democratic Republic of the</option>
<option value="Congo, Republic of the">Congo, Republic of the</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="East Timor">East Timor</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Polynesia">French Polynesia</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="North Korea">North Korea</option>
<option value="South Korea">South Korea</option>
<option value="Kosovo">Kosovo</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos">Laos</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macedonia">Macedonia</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia">Micronesia</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine, State of">Palestine, State of</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russia">Russia</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten">Sint Maarten</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Sudan, South">Sudan, South</option>
<option value="Suriname">Suriname</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="Togo">Togo</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
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Skip to main content * facebook * youtube * instagram * phone A Message from Dr. Ariel Perez on COVID-19. Let's discuss your options: (619) 832-2230 * Privacy Policy * Disclaimer Hit enter to search or ESC to close Close Search Menu * Why Choose Us * Diseases We Treat * * View All Disease Types * Breast Cancer * Prostate Cancer * Lung Cancer * * Stomach Cancer * Liver Cancer * Colorectal Cancer * Melanoma * * Soft Tissue Sarcoma * Ovarian Cancer * Uterine Cancer * Esophageal Cancer * * Pancreatic Cancer * Lymphoma * Our Treatments * * Cellular Nutrition * Detoxification * Immune Support and Regulation * Cryoablation * * Cancer Supression * T Cell Modulator Therapy * CAR T-Cell Therapy in Mexico * Immunotherapy * * Hyperthermia * Hipec procedure * Non-Chemo IPT * Preconditioning Treatment * Testimonials * About us * Patient Experience * Integrative Assessment * Follow Up * Travel Information * Financial Aid * Our Medical Team * Facilities * Contact Us * Help & FAQs * Blog * Phone Consultation A WHOLE-PERSON APPROACH TO CANCER TREATMENT IN MEXICO AT IMMUNOTHERAPY INSTITUTE AT THE IMMUNOTHERAPY INSTITUTE WE’RE HEALING THE MIND, BODY AND SPIRIT OF CANCER PATIENTS FROM AROUND THE WORLD. REQUEST TREATMENT INFORMATION * Your First Name* * Your Last Name* * Relationship to Patient* Choose One:MyselfSpouseFamily MemberFriendOtherMyself * Patient First Name* * Patient Last Name* * Email* * Phone* * Cell Phone * Country* Choose One:United StatesCanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Choose One: Choose One: * Cancer/Disease Type* Choose One:AdenocarcinomaAdrenal CancerAnal CancerAppendix CancerBile Duct CancerBladder CancerBone CancerBrain CancerBreast CancerCarcinoid TumorsCervical CancerColorectal CancerEndometrial CancerEsophageal CancerEye CancerGallbladder CancerGastrointestinal Stromal TumorsHead & Neck CancerHodgkin LymphomaIntestinal CancerKidney CancerLeukemiaLiver CancerLung CancerLymphomaMelanomaMesotheliomaMetastatic Squamous Neck CancerMultiple MyelomaNeuroblastomaNon-Hodgkin LymphomaOral CancerOvarian CancerPancreatic CancerPenile CancerPrimary Central Nervous System (CNS) LymphomaProstate CancerSarcomaSinus CancerSkin CancerSmall Intestine CancerSpinal CancerSquamous Cell CarcinomaStomach CancerTesticular CancerThroat CancerThymoma / Thymic CarcinomaThyroid CancerUrethral CancerUterine CancerVaginal CancerVulvar CancerOther Choose One: Choose One: * CAPTCHA * Hidden * Yes, mail me an info packet * * Add Additional Comments * Street Address * State / Province * City * Zip / Postal Code * Additional Comments * * * * ITI Form ID * Contact Fax * Name This field is for validation purposes and should be left unchanged. Δ DISCOVER THE LIFE-CHANGING IMPACT OF IMMUNOTHERAPY FOR CANCER TREATMENT. Watch inspiring patient testimonials from those who have battled a range of cancers, including lung cancer, breast cancer, and more. At the Immunotherapy Institute, our cutting-edge treatments and compassionate care can help you on your journey to recovery. Join us and explore our innovative approach to cancer care today. Watch More Testimonials WHY CHOOSE US WE KNOW THAT OUR PATIENTS DO CAREFUL RESEARCH… ...before choosing an alternative cancer treatment program in Mexico. We’re confident that Immunotherapy Institute offers the most advanced, successful program in Tijuana. Learn More OUR TREATMENTS THE GOAL OF OUR PROGRAM IS… ...remission, regardless of what challenges we face - all under the absolute golden rule: maintaining the patient’s quality of life. Find Hope PATIENT EXPERIENCE WHAT DRIVES THE OVERALL EXPERIENCE FOR OUR PATIENTS… ...is the idea that the patient is the leader of our medical team. See Our Story MEET OUR TEAM THE MISSION OF OUR TEAM IS NOT JUST TO ANALYZE AND TREAT THE PATIENT… ...but also to empower them with the tools to understand their disease and how to beat it. Meet Our Team MEET OUR TEAM Meet the dedicated world-renowned medical team at our alternative cancer treatment center in Tijuana, Mexico. DR ARIEL PEREZ CARBAJAL Director of Functional Medicine DR ALEJANDRO MARTINEZ NAVA Clinical Oncologist DR ALFONSO MARTINEZ Lead treating physician ANDRES MERAZ Treating physician DR. CESAR AMESCUA Pain Management Specialist ANETTE SOLORIO Clinical Nutritionist ‹› CANCER TYPES & TREATMENTS Every treatment and therapy we offer at Immunotherapy Institute has been evaluated in medical laboratories. BREAST CANCER Breast cancer is the second most common cancer among American women, only behind skin cancer. About 250,000 women in … Read More PROSTATE CANCER Roughly one in five men in the United States will be diagnosed with prostate cancer during their lifetime … Read More LUNG CANCER Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. Lung cancer claims … Read More PROSTATE CANCER Roughly one in five men in the United States will be diagnosed with prostate cancer during their lifetime. READ MORE STOMACH CANCER Over one million cases of gastric cancer are diagnosed each year around the world. Stomach cancer is the 5th most commonly diagnosed cancer in the world … READ MORE LIVER CANCER Liver cancer happens when normal cells in the liver change into abnormal cells and grow out of control. The liver is a big organ in the upper right side of the belly … READ MORE COLORECTAL CANCER Colorectal cancer (CRC) is a common and potentially lethal disease. It is estimated that approximately 145,600 new cases of large bowel cancer are diagnosed annually in the United States … READ MORE BREAST CANCER Breast cancer is the second most common cancer among American women, only behind skin cancer. About 250,000 women in … READ MORE LUNG CANCER Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. Lung cancer claims … READ MORE MELANOMA Melanoma is a serious form of skin cancer. It happens when normal cells in the skin change into abnormal cells and grow out of control … READ MORE We Treat ALL Cancer Types SOFT TISSUE SARCOMA Young adults experience the lowest incidence of soft tissue sarcomas, but occurrence steadily increases until the age of 50. READ MORE OVARIAN CANCER Ovarian cancer is the second most common cancer of the reproductive organs among women in the United States. It most commonly occurs in women between the ages of 50 and 65 READ MORE UTERINE CANCER Uterine cancer is the most common gynecologic cancer. Uterine cancer rates are highest among black women and are increasing among all women READ MORE ESOPHAGEAL CANCER Squamous cell carcinoma (SCC) and adenocarcinoma account for over 95 percent of esophageal malignant tumors READ MORE PANCREATIC CANCER Multiple factors, including a complex and poorly understood pathophysiology and difficulty in early detection and diagnosis make successful treatment of pancreatic cancer extremely challenging. READ MORE LYMPHOMA A lymphoma is a group of blood cell tumors that develop from lymphocytes, which are the white blood cells of your body’s immune system … READ MORE OTHER CANCER TYPES Many of our patients come to Immunotherapy Institute cancer clinic after they’ve been told to give up—that there’s nothing medicine and doctors can do for them READ MORE Diseases We Treat THE IMMUNOTHERAPY INSTITUTE PROTOCOL SIX STEPS TO HELP YOU BEAT CANCER THE HOLISTIC ASSESSMENT The Holistic Assessment is our first step, where our multidisciplinary team composed of oncologists, surgeons, nutritionists and holistic medicine experts tailor treatment based on the individual needs and medical history of the patient. CELLULAR NUTRITION Cellular Nutrition is an ongoing stage that is designed to make the patient’s body stronger and healthier so that it can better endure treatment and minimize side-effects. DETOXIFICATION The Detoxification process begins following the initial assessment and is a key element to the management of any type of chronic degenerative diseases including cancer. IMMUNE SUPPORT AND REGULATION Our immune system support and regulation therapies play a critical role in the fight against cancer, here we relieve the body of chronic inflammation that compromises the body’s defense system and prevents it from fighting cancer. CANCER SUPPRESSION Our cancer suppression strategy employs the combination of proven therapeutic cancer treatments that have been scientifically tested to reverse the effects of cancer or to completely cure cancer. FOLLOW UP Our Follow Up Program sets us apart from other programs. We follow our patients for three years after treatment to give them the tools to help them stay in remission. ABOUT IMMUNOTHERAPY INSTITUTE Our team has over twenty years of experience in alternative medicine and natural cancer therapy. We take pride in going above and beyond to deliver both the best treatment and an outstanding experience to every patient. Because we limit how many patients we see at one time, we are able to provide attentive care of the highest quality. Contact us by phone: (619) 832-2230 Address: Diego Rivera 2339, Zona Urbana Rio Tijuana, 22010 Tijuana, B.C. DISEASES WE TREAT * View All Disease Types * Breast Cancer * Prostate Cancer * Lung Cancer * Stomach Cancer * Liver Cancer * Colorectal Cancer * Melanoma * Soft Tissue Sarcoma * Ovarian Cancer * Uterine Cancer * Esophageal Cancer * Pancreatic Cancer * Lymphoma OUR TREATMENTS * Cellular Nutrition * Detoxification * Immune Support and Regulation * Cancer Supression * T Cell Modulator Therapy * Immunotherapy * Hyperthermia * Hipec procedure * Non-Chemo IPT * Preconditioning Treatment ABOUT US * Survival Rates * Patient Experience * Integrative Assessment * Follow Up * Testimonials * Travel Information * Financial Aid * Our Medical Team * Facilities * Blog * Contact Us © 2020 Immunotherapy Institute * Privacy Policy * Disclaimer Menu A Message from Dr. Ariel Perez on COVID-19. 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