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Take this 2 minute brief survey to see if Ketamine therapy is right for you
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Let’s start with your name:
(Required)
First
Last
We are only accepting patients 18+. What is your date of birth?:
(Required)
Month
Day
Year
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Age
Sorry we are currently accepting patients 18+.
Our therapies are currently available for residents in California, Texas, Florida, Washington, Colorado, Georgia, Massachusetts, Tennesse, New Jersey, Arizona, Virginia, Illinois, Connecticut and Wisconsin. What state are you located in?
State
(Required)
Select your state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip Code
(Required)
We are coming to your state soon - for early access enter your preferred email here and you will be first to know when we are live in
What is your sex assigned at birth
(Required)
Male
Female
Prefer not to disclose
How are you feeling? (Choose all that apply)
(Required)
I feel depressed
I feel anxious
I have PTSD
I have bipolar disorder
Other
How are you feeling? (Other)
Are you currently working with a therapist?
(Required)
YES
NO
How familiar are you with the benefits of ketamine therapy for anxiety, depression, bipolar, and PTSD?
(Required)
Very familiar
Somewhat familiar
Not at all
What is your goal with our program? (Choose all that apply)
(Required)
Find relief from depression
Get mental clarity
Get off my medications
Mental reset
Improved motivation
Stress relief
Other
What is your goal with our program? (Other)
What key areas are you hoping to improve?
(Required)
Professional life
Social interactions
Sleeping
Trouble relaxing
Personal Goals
Other
What key areas are you hoping to improve? (Other)
Are you interested in participating in a comprehensive mind-body wellness program that involves lifestyle modifications?
(Required)
YES
NO
MAYBE
Have you benefited from ketamine treatments in the past?
(Required)
YES
NO
Are you breastfeeding or pregnant?
(Required)
YES
NO
Have you ever been diagnosed with schizophrenia, schizoaffective disorder, schizoid personality disorder, or psychosis?
(Required)
YES
NO
Do you currently have any thoughts about ending your life?
(Required)
YES
NO
Are you currently (or have you been in the last 3 months) using illicit drugs or substances?
(Required)
YES
NO
Our methods make it simple to personalize treatment for you.
We offer
free discovery calls
and walk you through our oral ketamine program, our unique dose discovery process, and how our treatment works.
Our expert medical team will answer all of your medical questions to safely and effectively find the right dose for you to create a customized ketamine treatment program.
Our unique discovery process finds the most effective dose for you. We’re here to support you each step of the way, ensuring you make the most of each experience.
Please enter your contact information
Phone Number
(Required)
Email
(Required)