Health Institute de

Tijuana, Mexico

Clinic Application

Dear Sir or Madam, Thank you for your interest in the Gerson Therapy. To be considered for admission to the licensed facility in Mexico, H.I. de Tijuana S.C., your case needs to be evaluated by the clinic's doctors, to make sure that you are physically able to do the Gerson Therapy. H.I. de Tijuana S.C. is located in Playas de Tijuana, Mexico. This clinic is a separate, privately-owned business run by Gerson-trained doctors. However, it is licensed by the Gerson Institute, which ensures that patients receive true Gerson care. Your case can be evaluated at no charge, a service that the Gerson Institute facilitates as a non-profit organization. We also coordinate the application process for patients considering going to the clinic. The minimum stay at the clinic is two weeks but we recommend a three-week stay for optimal results. The cost for the treatment is $5,500 US per week. Patients are required to bring a companion - i.e. spouse, relative, friend- to assist the patient during their stay. The $5,500 US per week includes room and board for the companion. Please submit the medical records on the attached list along with the enclosed Medical Summary and Medical Records Release forms. After the Gerson clinic doctors have reviewed all the information, we will contact you within four business days. If you are approved, we will send you an Admission packet with information on payment, transportation, what to bring, and permission forms. We look forward to hearing from you. Sincerely, Education Department The Gerson Institute PO Box 161358 San Diego, CA 92176 P. 858.694.0707 F. 858.694.0757 info@gerson.org www.gerson.org

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Contraindications and Cautions Before Applying to the Clinic

While the Gerson Therapy is remarkably effective at treating a wide range of chronic degenerative diseases, some conditions require significant modifications to the treatment, and for others the Therapy is not recommended at all. Before applying to the clinic, please read the information below on precautions that should be taken for certain diagnoses. Surgical considerations for early-stage breast cancer patients The Gerson Institute would like to make all breast cancer patients aware that through the years the Gerson Doctors have observed that the benefit of the Gerson Therapy is enhanced when the body does not have to break down a tumor mass first while trying to eliminate other infiltrating cancer cells. Each case needs to be evaluated individually based on the size of the tumor, the histopathology report indicating how aggressive the cancer is which can be discussed with your doctor. However, for a patient with a recent breast cancer diagnosis of a Stage I-III with a small tumor, surgery should be considered. The patient may choose to have surgery before starting the Therapy or apply the Therapy for several weeks to enhance immunity and then have the surgery. If one elects to not have surgery, then it is advisable to monitor the size of the tumor mass closely with an MRI on a regular basis and if the tumor is not getting smaller, then one should reconsider the option of surgery. Multiple Myeloma Multiple myeloma is a malignancy of plasma cells, which are white blood cells that make antibodies. These cells invade and destroy adjacent bone tissue. Multiple myeloma produces non-solid tumors, and is somewhat similar to leukemia. The Gerson Therapy has encountered challenges in dealing with multiple myeloma, especially since discontinuing the raw liver juice. A patient may initially reap some benefit from the nutrition and detoxification the Therapy provides, but we have not seen sustained benefit. So, the Gerson Therapy may not be advisable as a sole treatment. If someone decides to pursue the Gerson Therapy, they may be advised to integrate certain conventional therapies such as bisphosphonates, a line of prescriptions drugs that help to slow down bone breakdown. They will also need to introduce additional protein into the diet earlier. Chronic Fatigue Syndrome/Chemical Sensitivity and Fibromyalgia Many of these patients have lead or mercury poisoning and may be Epstein-Barr virus (EBV) positive. The Therapy can work well for these conditions, but patients may not see significant improvement for a few months and they may experience many ups and downs during this time. They may feel worse (more toxic or depleted) in the early stages of the Therapy, especially after coffee enemas. Because of these strong detox reactions, which can include depression, crying and anger, the clinic prefers people to start the treatment at home and is not accepting applications with this condition at the present time. Contact the Gerson Institute to find out other services to help you start the Gerson Therapy at home.

Pacemakers A pacemaker is a foreign object and the Gerson Therapy has the potential to stimulate a healing reaction at the site of the pacemaker. This could cause a cardiac emergency and be very dangerous to the patient and put their life at risk. It is possible to apply a much reduced version of the Therapy for overall health enhancement, but would not likely to be enough to heal a cancer diagnosis. However, it may be possible to follow a very reduced protocol at home and improve one's overall health condition. This advice also applies to cardiac stents and cardiac valve replacements. The clinic is not accepting applications with this condition. Contact the Gerson Institute to find out other services to help you start the Gerson Therapy at home.

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Sarcoma It must be noted that sarcomas are difficult cancers to treat unless diagnosed early when the size of the tumor is small and can be easily excised with clear margins, and there have been no metastasis. Under these circumstances patients will have the best chance of doing well on the Gerson Therapy and will be considered for treatment at the clinic. However, if a patient has a more advanced condition than described above, it is unlikely they will be accepted at the clinic and should consider alternatives to using Gerson as a stand alone treatment.

The clinic is not accepting patients with any of the following conditions:

∙ organ, stem cell or bone marrow transplant recipients

∙ on kidney dialysis

∙ acute leukemia

∙ brain cancer or brain metastases

If you have any further questions about the application process or your specific condition, don't hesitate to contact our Education Department at 858.694.0707 or at info@gerson.org.

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Exceptions to the two-week minimum stay

The clinic will allow some nonmalignant patients to come to the clinic for 1 week rather than 2. All perspective patients will still need to apply to the clinic in the same manner, and decisions for length of time will be at the discretion of the clinic. Patients accepted for 1 week will be treated just as any other patient --laboratories, medical consultations, foods, enemas, supplements etc. --and therefore the cost of $5,500 per week will remain the same. Lastly, these patients will still need to bring a companion unless otherwise directed by the clinic.

See the list below for conditions that HI de Tijuana may be willing to accept for 1 week:

· Detox, healthy patient

· Diabetes, type 2

· Obesity

· Hyperlipidemia

· Degenerative Arthritis

· Glaucoma

· Heavy metal toxicity, mercury

· Psoriasis

· Eczema

· Fatty Liver Disease

· Migraines

· Osteoporosis

· Premenstrual Syndrome

· Fibrocystic breast disease

When reviewing applications, the clinic will base their decision for 1 week acceptance on a patient's condition and overall health. The clinic has the right to recommend a minimum two-week if they feel it is best for patient's treatment.

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Required Documents ChecklistMedical Summary Form, pages 7-9. All fields must be completed.

Medical Records Release Form, page 10.

Photo ID (i.e. driver's license or passport)

Most relevant medical events from the past year. We are simply looking for a medical summary regarding your health

in the past year. If you don't have such documents you can write a letter summarizing your health situation.

Pathology Report (Biopsy), CT scan, MRI, Ultrasound, or X-Ray written report(s) this report must be less than

6months old at the time of submitting the application for evaluation. Please include at least one of these reports that

confirm your diagnosis.

Complete Blood Count with differentials (CBC)- This report must be less than 3 weeks old based on collection date at

the time of submitting an application for evaluation.

Comprehensive Metabolic Panel Blood (CMP)- This report must be less than 3 weeks old based on the collection date

at the time of submitting an application for evaluation.

Complete Urine Analysis (urine culture is not accepted)- This report must be less than 3 weeks old based on collection

date at the time of submitting an application for evaluation.

Please call the Gerson Institute if you need samples of laboratory. If you are not able to get lab work ordered by your

doctor, laboratory reports can be obtained without a prescription through www.directlabs.com (US only).

Note: Film or CD records are not accepted.

A passport is required to travel to and from the United States. For visa requirement please visit www.usembassy.gov

How to submit your application: · Fax your application and all required document at +1.858.694.0757 or mail it to the Gerson Institute to:

4631 Viewridge Ave, San Diego, CA 92123. We cannot accept applications by e-mail.

· If you live outside the U.S., please fax your application and required documents. We don't recommend sending the application by regular mail, as this may delay the evaluation.

· At this time, we are only accepting medical records and laboratory reports in English or Spanish.

What needs to be included in your application: ·Please see the Required Documents Checklist below, which details the medical records and laboratory reports that are

required.

·Please do not submit your application until it is complete and includes all the required documentation.

·Please do not send more than 30 pages total. If you have more than 30 pages, please choose the most relevant medical reports from within the past year.

Only send in your completed application with all the required medical records and blood work. Incomplete applications will be put on hold until the rest of the required documents are received.

Collection date:

Collection date:

Collection date:

PLEASE ANSWER ALL QUESTIONS AND PRINT CLEARLY. DO NOT USE ABBREVIATIONS.

MEDICAL SUMMARY FORM

First name: Last name:

Street address: City:

State/Province: ZIP Code:

email:

Country:

Main phone:

Alternative phone:

Alternative person to contact: Relation to patient:

Phone:

Female

MaleAge:

MM/DD/YYYY

Height:ft

mlb

kgWeight:

Languages you speak:

Date of Birth:

Middle initial:

1. Primary diagnosis:

2. Original date of diagnosis:

4. Describe any metastases:

3. Location of primary tumor (if any):

6. Stage (I - IV):5. Type of cancer: 7. Grade:

Spouse Name:

ONLINE FORM

If yes, number of cycles:

8. Chemotherapy use?

Date of last treatment:

Date:

NoYes

Currently under chemotherapy

NoYes9. Radiation use? Date of last treatment: Currently under radiation

10. Hormone Therapy use: NoYes Date when treatment started:

NoYes11. Any surgeries within the past 5 years?

Description:

Date:

NoYes12. Was there any recurrences after treatment(s)?

Date:If yes, location:

NOTE: You must be off of chemotherapy treatment for at least 4 weeks before applying

If breast cancer, complete: ER + ER - PR + PR - HER2/neu + HER2/neu -

Type:

BRAC I BRAC II

Intraductal (DCIS)

Intraductal

Intralobular (LCIS)

Intralobular

Inflammatory

Other:

Date discovered:

I.V.Oral

Name of medication:

14. How frequent do you have a bowel movement?

NoYes

15. Are you bedridden ? NoYes

13. Are you able to eat and drink ?

NoYes16. Do you have any difficulty walking ?

NoYes17. Do you require a wheelchair?

NoYes18. Are you on dialysis ?

19. Do you require oxygen? Yes No

NoYes If yes, was the fluid removed? NoYes20. Any fluid in lungs/chest cavity?

If yes, describe:

Volume removed: Date:

NoYes21. ¿Any fluid retention in abdomen ?

NoYes22. Do you have a colostomy ?

NoYes23. Do you have an ileostomy ?

NoYes24. Any internal or external bleeding ?

NoYes25. History of mental/emotional illness?

NoYes27b. Do you currently smoke?

NoYes28. Do you drink alcohol?

If yes, was the fluid removed? NoYes

Volume removed: Date:

NoYes29. Do you do any exercise activities?

NoYes30. Have you recently lost weight?

NoYes31. Have you ever been exposed to agricultural, occupational or environmental chemicals/toxins?

36. Please check any of the following factors or symptoms that you are currently experiencing (check all that apply):

Diabetes Type I

Heart problems

Hepatitis

Epilepsy

Arthritis

HypertensionAsthma

Respiratory problems

Nausea/Vomiting

Blood clotting problems

Allergies to foods or drugs:

NoYes26.Have you ever taken any recreational drugs?

IV access portRoot canals

Coronary stent - when placed?

Steel plate/screws

Heart valve

Breast implantsBiliary stent

Abdominal teflon mesh

37. Do you have any foreign bodies?

IUD Saline Silicone

Mouth abscesses Mercury fillings

32. What do you do for a living? 33. How many hours do you work per week?

34. Where were you raised?

35. Have you had any accidents or injuries in the past?

If yes, describe:

If yes, describe:

If yes, which ones? how much and for how long?:

Frequency and quantity:

Frequency and quantity:

If yes, describe:

If yes, how much and since when?

If yes, describe:

Gluten intolerance Celiac

Pacemaker

Fibromyalgia/Chronic Fatigue/Chemical Sensitivity

Pneumonia

times/day

Organ transplant Stem cell transplant

Kidney disease History of stroke Diabetes Type II

Frequency and quantity:NoYes27a. Have you ever smoked?

times/weekor

Bone marrow transplant

Date:

45. Energy level: 46. Pain level:

Patient's signature:

N/A Low Medium High HighMediumLowN/A

4 oz8 ozVolume of each juice: Orange:Carrot:Green:Carrot/Apple:

41. How many coffee enemas do you take daily?

How many of each?:

40. How many juices a day do you drink?

42. Please describe your daily meals:

CoffeeFruits

Apple sauceHoneyRye bread

Orange juice

YogurtOatmeal

Other:

Salad

Rice

Hippocrates soup Cooked vegetables Potato Bread Sweets

Dinner:

Lunch:

Breakfast:

38. Please describe your diet as a child/adolescent

39. Please describe your diet as an adult (before diagnosis)

Please describe your current diet by answering the following questions:

When did you start taking juices?

When did you start taking them?

Other:Tea Milk

Bacon Eggs Bread

Cereal Sweets

Meat (chicken, beef, fish, pork) Pasta Fried foods

43. Prescription Medications you are currently taking:

44. Supplements you are currently taking:

I certify that all answers to the above questions are honest and accurate to the best of my knowledge.

Do you eat an organic diet? NoYes

Rev. 03.2015

Snacks:Fruit

Sandwich Beans

Baked goods Yogurt Fast food

Fast foods

Vegetables Crackers Sweets

Other:

Other:

Salad

Rice

Hippocrates soup Cooked vegetables Potato Bread Sweets

Meat (chicken, beef, fish, pork) Pasta Fried foods

Sandwich Beans

Fast foods

Vegetables Crackers Sweets

Fast foodYogurtBaked goodsFruit

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Medical Records Release Form

I

to release copies of any and all medical and administrative records to the H.I. de Tijuana S.C., that are required to be

considered for admission to the clinic.

Patient's Signature Date

Print name

hereby authorize the Gerson Institute

Only send in your completed application with all the required medical records and blood work. Incomplete applications will not be accepted.

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Frequently Asked Questions about the Clinic • How can I apply to become a patient at the H.I. de Tijuana?

You can download the clinic application here. The application has a medical summary form that you will need to fill out, and a list of the medical records and blood tests required for evaluation. Please fax or mail the complete application to the Gerson Institute, as instructed on the application. We cannot accept applications by email. Once we receive a patient's complete application, they can expect to hear back within two business days.

• Do I need to come in for a consultation or appointment first? Should I come to the clinic or the Gerson Institute

to apply in person? No, the clinic doctors do a thorough evaluation of each individual case, based on the patient's

medical records and blood work, to determine if they are a good candidate for the Gerson Therapy. The application is sent to by fax or by mail; there is no need to apply in person or come in for an appointment.

• How quickly can I be admitted to a treatment center? Is there a long waiting list?

You must go through the application process and be accepted as a patient before we can reserve you a room and arrange for your arrival. It usually takes about 15 days from the time a patient is accepted to the time they can arrive to check in at the clinic.

• Does the clinic accept any kind of payment plans? Can I pay in installments, or use a credit card?

No, the fees for the clinic can only be accepted upfront, prior to the patient's arrival at the clinic. The clinic is usually not covered by insurance or Medicare.

• Do I need to bring someone with me?

Yes. Every patient is required to bring a companion with them, and their fees are included in the total cost of treatment. The patient can be a friend, relative, spouse, or any person who will be assisting him or her with the Gerson Therapy at home.

• What is the role of the companion? Will they undergo the Gerson Therapy as well?

The companion comes to support the patient, and to learn the Gerson Therapy, so that they can assist the patient in continuing to implement the Gerson Therapy once they return home. Room and board are provided for the companion, as well as three Gerson meals with three juices per day. As the companion is not attending the clinic as a patient, they do not undergo the full Gerson protocol.

• How many patients can stay at the clinic at one time? There are 10 rooms at the clinic in Mexico, so we can accommodate 10 patients and their companions

at a time.

• How do I get to the clinic? Do I fly into Tijuana or San Diego? Do I need a passport to enter the country? Most patients fly in to San Diego International Airport, as it is the major airport closest to the

clinic. There is a paid transportation service, which can take you from San Diego down to the clinic's front door. It is necessary to have a passport in order to re-enter the United States. Please, do not make any travel arrangements until you have been accepted as a patient.

• Is Tijuana safe? I've heard a lot of bad reports in the news about the drug wars down in Mexico.

While we are aware of people's safety concerns regarding Tijuana, our patients have never had any troubles in that regard, and we take every precaution to ensure our patients' security. A paid transportation service takes patients directly from San Diego to the clinic's front door. H.I. de Tijuana is located in a safe, suburban neighborhood by the beach.

Frequently Asked Questions about the Clinic (Cont.) • Do the doctors and staff speak English?

Yes, the doctors and staff at H.I. de Tijuana are all fluent in both English and Spanish. If the patient does not speak English or Spanish, they will need to bring a companion who can translate for them.

• When will I start to see results? Will a two-week stay at the clinic be enough to rid me of my illness completely?

When a patient goes to one of our clinics, they are merely beginning the healing process. A cancer patient will need to follow the Gerson Therapy for at least two years after leaving the clinic. Most patients will go through their first healing reaction within the first week or two, and will begin to see changes in their blood work in that time period as well. There is no set timeline for when a patient will begin to see physical changes such as tumor reduction or elimination --healing is a very individual process, and there are many variables that affect how long it can take for a patient to heal (i.e., diet, diagnosis, whether or not a patient has already been through conventional treatments, etc).

• What happens after I leave the clinic? Do I need to return to the clinic for check-ups?

After you leave the clinic, you will go home and continue the Gerson Therapy protocol as prescribed by the clinic doctors. Most patients do not return to the clinic, unless they opt to return for another stay there. Patients do follow-up consultations with the doctors by phone, by sending their blood work and medical records for the doctors to review, so that the doctors can track their progress and adjust the protocol as needed.

• I am currently undergoing chemotherapy. Can I still apply to the clinic while I am taking chemo?

No. Chemotherapy works in conflict with the Gerson Therapy, which detoxifies the body in order to restore the body's natural defenses. If a patient has undergone chemotherapy, he/she needs to wait a minimum of 4 weeks after the last treatment to send his/her application. At that point, they need to begin the Gerson Therapy at a modified level, so that they do not detoxify too quickly. For this reason, we recommend that any patient pre-treated with chemotherapy begin the Gerson Therapy at a clinic, so that they can be safely and gradually introduced to the therapy under a doctor's supervision.

• I'm very interested in undergoing the Gerson Therapy, but I simply can't afford to go to a clinic. What other

options do I have? The Gerson Therapy can be self-administered entirely from home, using the instructions in the

Home Package, the set of books and DVDs that contain the full instructions for the Gerson Therapy. Ideally, a patient undergoing the Gerson Therapy from home would see a licensed Gerson practitioner, but if there are no local Gerson doctors, it is best to follow up with a naturopath, or a doctor friendly to and familiar with natural healing. A patient doing the therapy from home can also look into hiring a certified caregiver or attending one of our Gerson Basics Workshops to learn the basics of the Gerson Therapy so that they can practice it from home.

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