Rebuilding Lives

With Ketamine.

Klarisana: Rebuilding Lives

Forms and Assessments

1- New Patients

Complete the Contact us form to get started.

2- Next Steps

Fill out the Intake and Consent Forms.

3- Insurance?

Use our File Upload Form to submit a copy of your insurance card and identification.

Additional Administrative Forms

If you want Klarisana to share your treatment records with outside professionals:
Release of Information – Medical Providers

If you want Klarisana to share scheduling, treatment and financial information with your family & friends:
Release of Information – Family & Friends