Patient Intake
Renew hope.
Begin yourHEATT®
evaluation.
A confidential intake for advanced cancer and chronic-disease patients. Share your history and current treatments so our clinical team can determine whether Whole-Body Hyperthermia Therapy is appropriate for you.
Two ways to submit
Online or on paper — your call.
Both options deliver your intake to the same Verthermia clinical inbox. Choose whatever feels easiest for you.
Complete the secure web form
About 8–12 minutes. Auto-saves nothing locally; submits directly to our clinical inbox.
Print the cancer intake & fill by hand
The cancer-specific packet. Includes a QR code to submit online from any device — or upload a photo of the completed pages.
Print the disease intake & fill by hand
The Lyme / syphilis / other-disease packet — only the questions relevant to chronic & infectious disease.
Upload completed pages
Snap photos or scan a PDF of pages you filled out by hand — we'll take it from there.
What we'll ask
Three short sections.
Have your most recent treatment history nearby — pathology, prior therapies, and any current medications.
- 01
Patient profile
Name, age, height, weight, and best ways to reach you.
- 02
Diagnosis
Whether you're seeking care for a cancer or a chronic disease — with the specifics that apply (type, stage, co-infections).
- 03
Treatment history
Therapies undergone to this point — surgical, systemic, targeted, supportive.
Prefer to talk first?
Book a confidential call.
Speak directly with a HEATT® expert before you start the intake — no obligation. Tell us when works, and we'll call you.
When you're ready, we're here.
Your intake takes minutes. A real clinician reads every word.