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PATIENT PORTAL

Your journey towards health and happiness begins here. Please complete and/or review the following forms and policies prior to your initial consultation.

FORMS TO BE COMPLETED FOR KETAMINE INFUSION THERAPY

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Medical History Form for Ketamine Infusion Therapy

Please complete this brief medical history form for Ketamine Infusion Therapy.

Acknowledgement of Ongoing Care

Please print this Acknowledgement of Ongoing Care form and provide it to your primary care provider, psychiatrist, or therapist to be completed and returned to us for Ketamine Infusion Therapy.  Your provider may also complete the form online here.

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Privacy Policy

Please review and acknowledge your understanding of our Privacy Policy.
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Payment & Cancellation Policy

Please review and acknowledge your understanding of our Payment & Cancellation Policy.

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Electronic Communication Policy

Please review and acknowledge your understanding of our Electronic Communication Policy.

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Pay Online

Please pay for your treatments well in advance, via our secure online payment portal to guarantee your infusion appointment.

FORMS TO BE COMPLETED FOR IV HYDRATION THERAPY

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IV Hydration Therapy Forms

Please complete this brief medical history form, Informed Consent, Privacy Policy, Payment & Cancellation Policy, and Electronic Communication Policy.

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Pay Online

Please pay for your treatments well in advance, via our secure online payment portal, to guarantee your infusion appointment.

FORMS TO BE REVIEWED

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Informed Consent to Ketamine Infusion Therapy

Please review this consent for Ketamine Infusion Therapy

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Informed Consent to IV Hydration Therapy

Please review this consent for IV Hydration Therapy