Prior to your screening please complete and submit the Patient Intake Form, the Depression Inventory Assessment, and read through the Ketamine Information Package and sign at the bottom. The Patient Intake Form is also below if you prefer to print it out or if you plan to complete these forms in person please arrive 10-15 minutes early for your screening appointment.
We strongly encourage our patients to track their Depression on a regular basis. Complete the Depression Inventory Assessment form on a weekly or bi-weekly basis and submit it for the clinical staff to review and track the information.
If we need copies of your medical information released please print out the Medical Release Form, sign and email to email@example.com or fax 1-844-KET-WELL (1-844-538-9355).