Ready to become a patient? - Klarisana is dedicated to providing the highest quality of care along with the best possible outcomes for our patients. Once you complete the form below, a member of our team will reach out with more information. "*" indicates required fields Step 1 of 8 12% Where are you in your journey?Where are you in your journey?* Want more information Ready to get started Treated at another facility and would like to continue a treatment plan with Klarisana What’s your name?Name* First Name* Last Name* Hi! Why are you seeking treatment?Reason seeking treatments* Mental health condition Chronic pain Both Some additional infoEmail* Phone number*Date of birth MM slash DD slash YYYY Consent* I have read and agree to Klarisana’s website Terms and Conditions.*Consent* I have read and agree to Klarisana’s website Privacy Policy.* What’s your preferred clinic?*Preferred Clinic* Austin, TX Denver, CO San Antonio, TX Westminster, CO Longmont, CO Do you have insurance?Select insurance (if any)NoHumanaChamp VABaylor Scott & WhiteMedicareTricare EastFriday Health PlansSANA HealthTraditional MedicaidBlue Cross Blue ShieldUnited HealthcareCIGNATricareNot ListedDo you have secondary insurance? Yes No Select secondary insuranceHumanaChamp VABaylor Scott & WhiteMedicareTricare EastFriday Health PlansSANA HealthTraditional MedicaidBlue Cross Blue ShieldUnited HealthcareCIGNATricareNot Listed How did you hear about Klarisana?*How did you hear about Klarisana?* Provider referral Colleague or friend Internet search Internet ad Is there anything else we should know about?Message