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Book a Free Consultation

If you are in need of urgent assistance please call or text:
602-492-9821.

Please complete our patient intake form below to help us personalize your care.

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Personal Information(Required)
Date of Birth(Required)
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Health Information

Have you ever received any form of ketamine therapy (infusions, lozenges, Spravato, etc)?*(Required)
If none, type "n/a" or "none"
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If none, type "n/a" or "none"
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Have you ever experienced any of the following heath problems? *(Required)

Address:
18205 N 51st Ave STE 126,
Glendale, AZ 85308
Phone:
(602) 922-8527
Hours:
Mon - Thu: 7am–4:30pm
Fri: 8am–12pm
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