VIP Ketamine Clinics is Open During Covid-19

PATIENT INTAKE PORTAL

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

GET STARTED WITH KETAMINE INFUSION THERAPY AT OUR MODESTO, CA KETAMINE CLINIC

Everything you need to become a patient at our Modesto, CA ketamine treatment center is right here. Please complete these intake forms prior to your initial consultation at our office. We will review your forms prior to scheduling your first infusion. Thank you for choosing VIP Ketamine Clinics.

FORMS TO COMPLETE ONLINE

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Medical History Form

Please tell us a bit about your medical history.

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Privacy Policy

Please review & agree to our clinic’s Privacy Policy.

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Payment & Cancellation Policy

Please review & agree to our clinic’s Payment & Cancellation Policy.

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Consent to Electronic Communication

Please review & agree to receive communication for our clinic via non-secured electronic methods.

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Pay Online

We appreciate your advanced payment for ketamine infusion services.

FORMS TO REVIEW ONLINE OR PROVIDE TO YOUR HEALTHCARE TEAM

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Informed Consent to Ketamine Treatments

Please review this important information about ketamine infusion therapy prior to your first infusion.

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Acknowledgement of Ongoing Care

Please provide this form to your primary or mental health care provider and ask them to complete and fax the form back to our office.

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CALL US

209.314.3024

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EMAIL US

info@modestoketamine.com

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VISIT US

VIP Ketamine Clinics
205 Judith Lane
Modesto, CA 95350

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OFFICE HOURS

Monday-Thursday: 9am-5pm
Saturday: By appointment only
Sunday: Closed