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provider referrals

We believe in a comprehensive approach to patient care.  It is our goal to work with providers to provide supplemental assistance as part of ongoing therapies instead of a competing nature.  We all hope to work together to enhance the patient experience.  Our patients must be under the care of a licensed mental health provider.  We provide access to this life altering treatment and will follow the patient with periodic assessments that will be shared with the provider via mood monitoring.  The provider will continue to treat and manage patients for their mental health needs.  

Feel free to contact us by email, or phone

info@my-domain.com   |   123-456-7890   |   7am-5pm PST mon - fri

Provider Referral Form

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Bluegrass Ketamine Center values your privacy and assures you we will never give or sell your personal information to any third parties. All personal information you provide on our web site (i.e.: name, address, email address and telephone number) will be kept confidential and will only be used to provide services with Bluegrass Ketamine Center. Contractors of Bluegrass Ketamine Center who are given access to your personal information will be required to keep the information confidential and not use it for any other purposes other than the services they are performing for Bluegrass Ketamine Center.