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
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.
Privacy Policy
Payment & Cancellation Policy
Please review and acknowledge your understanding of our Payment & Cancellation Policy.
Electronic Communication Policy
Please review and acknowledge your understanding of our Electronic Communication Policy.
FORMS TO BE COMPLETED FOR IV HYDRATION THERAPY
IV Hydration Therapy & Intramuscular Injection Therapy Forms
Please complete this brief medical history form, Informed Consent, Privacy Policy, Payment & Cancellation Policy, and Electronic Communication Policy.
FORMS TO BE REVIEWED
Informed Consent to Ketamine Infusion Therapy
Please review this consent for Ketamine Infusion Therapy.
Informed Consent for IV Hydration Therapy & Intramuscular Injection Therapy
Please review this consent for IV Hydration Therapy.
Ketamine Pre-infusion Instructions
Please review these instructions prior to your ketamine infusion.
