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The evaluation process to become a patient at Mind Body Centers is as follows:

  • Complete the Patient Intake form
  • Read & sign the Ketamine Information Package
  • Complete the Depression Index
Required Intake Forms

I. Patient Intake Form

II. Ketamine Information Package

III. Depression Inventory Assessment

Other Forms

Medical Records Release & Request

Allows MBC to request medical records on your behalf.

Authorization for Communication

Required if patient wants someone else to communicate with MBC on their behalf.

Referral Program

Patient Referral Program