Pre-Screening & Intake Forms
KETAMINE INFUSION PRE-SCREENING & INTAKE FORMS
Prior to beginning your ketamine infusion therapy, it is important for us to understand and evaluate your level of depression and/or anxiety. This helps us identify any other conditions that may complicate your treatments, or render them ineffective.
Please review our Privacy Practices and complete the following forms prior to your first treatment:
Acknowledgement of Ongoing Care
To be completed by a referring physician or mental healthcare provider

CONTACT KETAMINE GREATER BOSTON
Complete the brief form below to contact our Boston area ketamine clinic and learn more about how this innovative depression treatment could change your life.

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EMAIL US

KETAMINE CLINIC LOCATION
109 Highland Ave, Suite 204
Needham, MA 02494
