PATIENT INTAKE PORTAL

Everything you need to begin your journey is right here.

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SUBMIT THE FOLLOWING FORMS ONLINE:

• Medical History Form

• Privacy Policy

• Payment & Cancellation Policy

• Consent to Electronic Communications

• Informed Consent to Ketamine Treatment

• Acknowledgement of Ongoing Care

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Medical History Form

Please tell us about your medical history so we can better meet your needs. Complete the form »

ketamine treatment pricing

Privacy Policy

Please review and agree to our privacy policy. Review the policy »

ketamine treatment pricing

Payment & Cancellation Policy

Please review and agree to our payment & cancellation policy. Review the policy »

ketamine treatment pricing

Consent to Electronic Communication

Please review our electronic communications policy and agree to receive communication via non-secured means. Review the policy »

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Pay Online

Please pay for your ketamine infusions prior to your appointment. Pay online now »

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Informed Consent to Ketamine Treatment

Please review this important information about ketamine treatments prior to your first infusion. Review the document »