Ketamine Treatment Inquiry


Estimated time to complete form : 1-2 minutes Estimated submission response time : 4-5 business days

Congratulations on taking steps towards a healthier existence, and towards getting the support you need. We are preparing to provide Ketamine treatments in the near future and are now accepting clients to be placed on our first-come, first-served waitlist. If this new treatment modality interests you and you wish to be contacted when appointment openings are available please fill out the short form below. We look forward to providing you with this exciting new treatment.


Briefly, please describe the diagnosis or issue you feel you would like to work on using Ketamine
If your referral came from a medical or mental health professional, please give their name & location.