*If you are a clinician referring a client or looking to collaborate please fill out this form I am: * Over 18 years of age and seeking care for myself Parent or guardian acting on behalf of a minor Name * First Name Last Name Email * Phone Number City and State * What are you reaching out about? * Medication management Ketamine assisted psychotherapy Alternative therapies Deprescribing I am a clinician looking to refer a client or collaborate Why are you seeking mental health treatment at this time? What are your mental health goals for treatment? Thank you!
