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
Consent to Electronic Communication
Please review & agree to receive communication for our clinic via non-secured electronic methods.
FORMS TO REVIEW ONLINE OR PROVIDE TO YOUR HEALTHCARE TEAM
Informed Consent to Ketamine Treatments
Please review this important information about ketamine infusion therapy prior to your first infusion.
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.
Phone or Fax: 209.314.3024
VIP Ketamine Clinics
205 Judith Lane
Modesto, CA 95350
Saturday: By appointment only