🔬 What If Everything You’ve Been Told About Beating Cancer Is Only Half the Story?

🎥 Discover The Survivor Protocol—A Groundbreaking, Research-Backed System To Target Cancer At The ROOT.

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📋 Apply Now90% of Cancer Deaths Are from Recurrence—Don't Let One Be You.

📝 Welcome to the Survivor Protocol: This comprehensive intake form will help us create a personalized protocol tailored specifically to your cancer journey. Please take your time with this.

What type of cancer(s) have you been diagnosed with? *

What stage is your cancer? *

When were you first diagnosed? *

Are you currently undergoing cancer treatment with a doctor? *

What treatments have you undergone? *

Have you had any cancer recurrence? *

Is this your first time filling out this intake form? *

Full Name: *

Your full legal name

Email: *

Your fully customized protocol will be sent to this email

Phone Number: *

For important updates about your protocol

Date of birth *

MM/DD/YYYY

Which phase of the Survivor Protocol are you currently on? *

Would you like to receive printed copies of your protocol by mail? *

Address

Street Address

Where we can send your printed protocol

City

State

Country

ZIP/Postal Code:

Do you have a doctor managing your cancer care? *

Primary Oncologist/Doctor's Name:

Your primary cancer care provider

Doctor's Email (optional):

For sharing protocol information if desired

Doctor's Office Phone (optional):

Would you like us to send protocol updates to your doctor?

Do you have a caregiver who assists with your health needs? *

Primary Caregiver's Name (if applicable):

Person who helps with your care

Caregiver's Relationship to You:

Caregiver's Email (optional):

For sharing protocol information if desired

Caregiver's Phone (optional):

Would you like to include your caregiver in protocol communications?

Do you have any other chronic health conditions? *

What is your current weight? *

Please specify pounds or kilograms

Have you experienced significant weight changes in the past 6 months? *

How would you rate your current energy level? *

How would you rate your current pain level? *

Scale: 0-10, where 0 is no pain and 10 is worst pain imaginable

How would you describe your sleep quality? *

How would you rate your current stress level? *

How would you describe your current diet? *

Do you have any dietary restrictions or food allergies? *

How much water do you drink daily? *

What is your primary source of drinking water? *

Do you exercise regularly? *

What type of exercise do you typically do? *

Do you smoke or use tobacco products? *

How much alcohol do you consume? *

How would you describe your home environment? *

Do you have concerns about EMF exposure in your environment? *

List all medications you currently take (include dosage and frequency): *

Medication 1:
Medication 2:
Medication 3:
Medication 4:
Medication 5:
Medication 6:
Medication 7:

Include prescription medications, dosage, and frequency. ex: Tamoxifen 20mg daily, Metformin 500mg twice daily

List all supplements you currently take (include brand, dosage, and frequency): *

Supplement 1:
Supplement 2:
Supplement 3:
Supplement 4:
Supplement 5:
Supplement 6:
Supplement 7:

Include supplement name, dosage, and frequency. ex: Vitamin D3 5000IU daily, Fish oil 1000mg twice daily

Do you have any medication allergies?

Describe Your Current Treatment Schedule: *

Include frequency and duration of current treatments

When is your next doctor appointment?

MM/DD/YYYY

What treatment facility do you primarily use?

Hospital or clinic where you receive most care

How much time can you realistically dedicate to health protocols each day? *

Do you have any physical limitations that might affect implementing health protocols?

What challenges might make it difficult to follow health protocols?

How much have you invested in your health and cancer treatment in the past year?

What's at stake for you in this fight?

Last Question: In your own words, tell us about your diagnosis: What you've tried, what's working, what isn't, and most importantly - what brought you here today. *

Share your cancer journey, specific concerns, goals, or any additional information.

Who referred you to us?

How you heard about the Survivor Protocol

Upload Your Recent Lab Work:

Upload PDF or image files of recent bloodwork (last 6 months if possible)

Recent Scans/Imaging:

Upload PDF or image files of recent scans or medical records

COMPLETE! Would you like to schedule a support call? *

Drink These 3 Anti-Cancer Shakes Daily To Help Prevent Cancer Stem Cells From Forming (Or Feeding) Tumors!

Remember, we are using these for off-label purposes based on their unique ingredients. All of the other benefits listed on their websites are an added plus. These products are NOT on Amazon or other websites - they're only available through the retailers below.

MORNING:

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Antioxidants prevent free radicals from mutating your normal stem cells to into cancerous ones that form tumors. This product has the most potent antioxidants on the market.

NOON:

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Anti-Angiogenesis prevents cancer stem cells from forming new blood vessels that steal nutrients and feeds them to tumors. Just about every ingredient in this shake blend is anti-angiogenic.

NIGHT

Grab Your Greens

Apoptosis causes cancer stem cells to "self-destruct" and die on their own, similar to a cell committing suicide. The greens in this product are known to stimulate apoptosis in cancer cells.

💡 Scientific References

The Survivor Protocol is not endorsed by, sponsored by, or affiliated with any of these organizations.

[1] Batlle, E., Clevers, H. Cancer stem cells revisited. Nat Rev Cancer 17, 215–230 (2017).

[2] Sands, J. et al. "Risk factors for recurrence after curative-intent treatment of stage I–II non-small cell lung cancer." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021) 8520-8520.

[3] Harvard Stem Cell Institute. "Cancer Stem Cells." https://hsci.harvard.edu/cancer-stem-cells

[4] Lytle, N.K., Barber, A.G. & Reya, T. Stem cell fate in cancer growth, progression and therapy resistance. Nat Rev Cancer 18, 669–680 (2018).

[5] Clevers, H. Cancer Therapy: Defining and Targeting Skewed Clones. N Engl J Med 380, 612-614 (2019).

[6] Lambert, A.W., Pattabiraman, D.R. & Weinberg, R.A. Emerging Biological Principles of Metastasis. Cell 168, 670-691 (2017).

DISCLAIMER: The information provided in "The Survivor Protocol" and on this website is for educational and informational purposes only. It is not intended as medical advice and should not be relied upon as a substitute for professional healthcare consultation. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website or in the provided materials. The supplements and nutritional guidelines mentioned in "The Survivor Protocol" have not been evaluated by the Food and Drug Administration (FDA) and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary, and the experiences of others mentioned in the eBook or website do not guarantee similar outcomes. By using this website and its content, you agree to indemnify and hold harmless the website owner, authors, and affiliates from any claims, damages, or losses resulting from the use of this information. By submitting your email address and phone number on this website, you are authorizing our company to send you informational and promotional messages via email, phone calls, and text messages. Additionally, this website contains affiliate links, and the owner may earn a commission if you make a purchase through these links.

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