SPINE INTERVENTION CLINIC | NEW PATIENT PORTAL

Welcome to Spine Intervention Clinic. As you prepare for your ketamine infusion experience, please review the following online documents and forms:

Medical History Form
Please provide us with some information about your medical history. 

Privacy Policy
Information about how your personal data will be stored and secured.

Cancellation Policy
Please review and agree to the terms of our cancellation policy.

 

Treatment Consent
View the terms and conditions of accepting ketamine infusions at Vitalitas

Acknowledgement of Ongoing Care
Please download, print and provide this form to your primary care physician or mental health specialist.