STEP 1 - REQUEST FOR MEDICAL INTAKE FORMS

We are committed to providing you with the highest level of care and personalized ketamine treatment plans. As part of this commitment, we require a medical intake to be performed prior to treatment, which includes a comprehensive evaluation by one of our experienced medical professionals.

Unfortunately at this time we do not provide ketamine to patients with a history of schizophrenia or psychosis, or who are currently pregnant.

It is also important to note that we currently do not accept health insurance for ketamine treatments.

If you are feeling suicidal, please call 988, 911, or proceed directly to your nearest Emergency Department for further evaluation.

Please enter your information below to access our initial screening and consent forms. Upon completion, we will determine your preliminary eligibility and will reach out to you with further information regarding scheduling a medical intake within one business day. 

Your medical intake appointment (Step 2) will allow us to finalize your eligibility for ketamine treatments.