XCell-Center GmbH Custodisstraße 3 - 17, 50679 Cologne, Germany (hereinafter referred to as “XCell-Center”),
and _________________________________________________________ (hereinafter referred to as the “Patient”)
have concluded the following treatment contract:
1.
a)Subject of contract
Within the scope of the contract, XCell-Center will provide the Patient with the following form of treat-
ment with adult stem cells:
Lumbar puncture
Angiography
Surgery
Direct Injection
IV
b)The medical examination as well as the harvesting and re-implantation of the stem cells are performed by
medical specialists in a harvesting facility approved by the responsible regulatory authority pursuant to
Art. 2 No. 11 of the German Ordinance on Good Manufacturing Practices in the Production of Medicinal
Products and Active Substances and the Application of Good Manufacturing Practice in the Manufacturing
of Products of Human Origin.
c)The harvested stem cells are processed in a tissue facility approved by one of the responsible authorities
pursuant to Art. 2 No. 10.
d)Both facilities work in compliance with the principles of good Manufacturing practice in the sense of Art.
3 Para. 1 of the AMWHV.
2. Remuneration
a)remuneration for stem cell treatment totals
EUR 7,545.00 for lumbar puncture.
EUR 8,925.00 for angiography.
EUR ________ for ________________
b)Remuneration is due for payment upon formation of this treatment contract.
c)The remuneration is to be paid in full even if the treatment does not take place for reasons in the Patient’s
sphere of influence.
3. Clarification
a)The Patient confirms that, before signing this contract, he/she received comprehensive information from
XCell-Center through a doctor regarding the course, prospective duration, scope and possible risks and
side effects of treatment with adult stem cells.
b)The Patient confirms that, before signing this contract, he/she was informed that successful outcome of the
treatment cannot be guaranteed.
c) The Patient confirms that he/she was informed that the above-mentioned therapy is not yet recognized as
a general treatment method pursuant to Art. 135 SGB V (German Social Code V) by the German Federal
Joint Committee (G-BA) and that the costs for the treatment will therefore not be reimbursed by the statu-
tory health insurance funds or private health insurance companies.
4. Guarantee, liability
a) XCell-Center guarantees proper and professional treatment with adult stem cells from the Patient.
b) XCell-Center does not guarantee the success of treatment.
c) Treatment can be expected to take 3 until seven calendar days. The Patient has been informed that this
figure is merely a non-binding estimate and that the duration of treatment may vary from this estimate
depending on the conditions in individual cases. XCell-Center assumes no liability for exceeding the treat-
ment duration if delays in treatment occur for reasons outside of Xcell-Center’s realm of influence.
5. Other contractual provisions
a) There are no collateral verbal agreements to this contract. Modifications and additions to this contract
must be in written form in order to be valid; this is likewise applicable to the rescission of the agreement
on written form itself.
b) The place of performance is Cologne / Düsseldorf.
c) If the Patient’s location of residence is not in the Federal Republic of Germany, the place of jurisdiction for
disputes arising from this contract is also Cologne.
d) German law shall apply with the exception of international civil law (Art. 3 to 46 of the German Introduc-
tory Law to the Civil Code - EGBGB) and UN Sales Law.
e) Should individual provisions of this contract be legally invalid or become so as a result of changes in legisla-
tion or alterations in court decisions, this shall not affect the validity of the rest of the contract. The invalid
provision shall be replaced with a valid provision which fulfills the intentions of the parties upon conclu-
sion of contract as closely as possible.
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