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ONLINE PROVIDER
ACKNOWLEDGEMENT OF ONGOING CARE FORM

TAHOE KETAMINE HAS PROVIDED THIS SECURE ONLINE ACKNOWLEDGEMENT OF ONGOING CARE FORM FOR YOUR CONVENIENCE.  PLEASE FILL OUT THE INFORMATION BELOW, THEN CLICK SUBMIT.  YOU WILL BE TAKEN TO ANOTHER SECURE PAGE TO SIGN THE INFORMATION THAT YOU HAVE SUBMITTED.  IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT US FOR ASSISTANCE.

 

You may review information about ketamine therapy at our practice website here. Our physicians welcome any questions you have.
***Psychosis and mania are contraindications to ketamine treatment.