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Patient Portal

Patient Forms

Please complete and submit the following forms prior to your first ketamine infusion:

Please review our Informed Consent to Ketamine Infusions form, as you will be asked to sign this at our clinic prior to your first appointment. The Acknowledgement of Ongoing Care form may be provided to your referring physician and faxed back to our clinic.

Medical History Form

Privacy Policy

Pregnancy Waiver

Treatment Downpayment

Informed Consent To Ketamine Treatments

& Cancellation Policy

Consent To Electronic Communication

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