Cost and Medical Forms

To become a patient at our clinic we will need a referral completed by your current psychiatrist and a copy of your last visit clinic notes.  This must be an MD or a DO physician.  We can NOT accept referrals from ANY other mental health care providers incl. MHNP, therapists or psychologists.

We will require that the referral be renewed on a monthly basis by your psychiatrist.

Below is a link to a blank referral form as a PDF.

Ketamine Referral PDF

If you need a psychiatrist please see the list below.

Seattle Psychiatric referral list PDF

Depression Treatment Cost:

1 hour consult (optional)     $375

Initial six ketamine infusions     $4050

Booster infusions     $675

All patients will need a single booster infusion every 4 to 6 weeks to keep depression symptoms controlled.

CRPS / RSD treatment costs:

$2500 per treatment which runs 4-6 hours each.

Most patients will require between 5-10 treatments depending on the amount of improvement observed.

Treatments are done over 10-15 day block.

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Medical Forms

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We have chosen to err on the side of safety by using more stringent exclusion guidelines than our purposes require when deemed necessary.  We reserve the right to refuse treatment based on our clinical impression.