In order to be a patient at Portland Ketamine Clinic you must have a referral from a psychiatrist. We can NOT accept referrals from ANY other mental health care providers incl. MHNP, therapists or psychologists. Patients will also be required to have monthly referrals from their psychiatrist.
Ready to become a new patient? Fill out this easy and secure form!
Medical Intake Form
Authorization to Release Medical Information Form
Psychiatric Referral Form
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