Apply for a Free Initial Screening

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Screening Application Form

Initial Screening

The initial screening form will allow us to determine if you are a good candidate to begin the pre-treatment process. Most applications will receive a response within 72 hours.

Intake Forms

If accepted you will receive a link to complete your medical history forms. Once completed you will receive a list of labs / exams that must be completed prior to treatment.

Packet Review

Once your forms, medical history, and labs / exams have been submitted for review, our medical team may provide final clearance.

Schedule Treatment

Once approved, you may book your treatment on your desired date, subject to availability.

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Screening Application Form

Complete this short form to find out if you are a suitable candidate for CELLAAX therapy at our Subang Jaya
centre or partner clinics. Most applications receive a response within 24–72 hours. A member of our team will
contact you via WhatsApp to discuss your case.

CELLAAX Sdn Bhd is PDPA compliant. Your information is
used solely to assess your candidacy for treatment and will not be shared with any third parties. Please note:
All therapies at CELLAAX are patient-funded programmes. Treatment approval is subject to pre-screening lab
results reviewed by our medical team.

Ready to Find Out If You Are a Candidate?

Our medical team reviews every application personally. The first step is a short online screening form — no commitment required.

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