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For services rendered by Ketamine Wellness Centers

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If the individual receiving treatment is not the same person who is submitting payment through this form.
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Which treatment are you paying for?
Please select from the treatment options below and make sure to select the quantity you are paying for, as well.
Screening Fee
The $100 fee required for KWC to conduct your medical and/or psychological screening with our intake professionals.
Price: $100.00 Quantity:
Mental Health Treatment
The $500 fee for a single ketamine treatment for a mental health condition.
Price: $500.00 Quantity:
Pain Treatment
The $750 fee for a single ketamine treatment for a chronic pain condition.
Price: $750.00 Quantity:
Facilitated Treatment Support Program
The $150 fee required to participate in the Facilitated Treatment Support program. This will cover six 30 minute sessions with the KWC Health & Wellness Coordinator and a FTS guidebook.
Price: $150.00 Quantity:
Total
$0.00

PHONE:
855-KET-WELL (1-855-538-9355)
FAX:
844-KET-WELL (1-844-538-9355)
CLINIC LOCATIONS:
Chicago, Illinois
603 E Diehl Rd, Suite #139 Naperville, IL 60563
Dallas-Fort Worth, Texas
6144 Precinct Line Road, Suite 100 Hurst, TX 76054
Denver, Colorado
7261 S Broadway, Suite 10-L Littleton, CO 80122
Minneapolis-St Paul, Minnesota
11995 County Road 11, Suite 220 Burnsville, MN 55337
Phoenix, Arizona
2152 S. Vineyard Plaza, Suite 131 Mesa, AZ 85210
Seattle, Washington
34709 9th Ave S. Suite-B 200 Federal Way, WA 98003
Tucson, Arizona
3130 N Swan Rd. Tucson, AZ 85712

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