Patient Intake Forms

Everything you need to begin your journey towards health and wellness is right here.

South Sound Ketamine Clinic Patient Intake Forms

Before scheduling your first appointment, please complete and/or review the following forms and policies:

Online Forms & Policies

Please complete your Medical History Form, review our Informed Consent to Ketamine Treatment, and provide the Acknowledgement of Ongoing Care form to your primary care or mental health physician, to be return to us prior to your first ketamine infusion.

Medical History Form

Please complete your Medical History Form online.

Treatment Consent

Please review our Treatment Consent document online.

Acknowledgement of Ongoing Care

Please download this form and provide it to your primary care physician or mental healthcare provider.