Healing Realms
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Ketamine Assisted Psychotherapy Information Sheet:
This document provides essential information about our KAP procedures, as well as about ketamine itself. 
kap_-_information.pdf
File Size: 157 kb
File Type: pdf
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KAP Practice Policies:
This document explains our policies regarding confidentiality, payment of fees, cancellations, professional medical records, and complaints.
kap_practice_policies.pdf
File Size: 116 kb
File Type: pdf
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Informed Consent for KAP:
Please review the Information Sheet and Practice policies before signing.

ic_for_kap.pdf
File Size: 43 kb
File Type: pdf
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KAP Preparation and Aftercare Handout:
These physical and psychological instructions will help optimize your experience and minimize ketamine's potential adverse side effects as much as possible.

Prep/Aftercare
File Size: 177 kb
File Type: pdf
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Integration Tips:
These are practices that can help you get the most benefit out of your treatment.
integration_tips.pdf
File Size: 90 kb
File Type: pdf
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Lozenge Instructions/Agreement:
This is to be read and completed before using ketamine at home as part of your work with Healing Realms.  
lozenge_agreement_-_03_24_2020_06_00_pm.pdf
File Size: 110 kb
File Type: pdf
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Referral Form:
This form may be used for your current mental health provider to refer you to our services.

kap_referral_form.pdf
File Size: 35 kb
File Type: pdf
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Authorization to Exchange Information:
This form may be used to authorize collaboration between us and any other providers you may have.

kap_exchange_of_info.doc.pdf
File Size: 121 kb
File Type: pdf
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Consent for Audio Recording:
Information and authorization for recording session material.
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recording_ic.pdf
File Size: 68 kb
File Type: pdf
Download File

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  • Ketamine
    • Psychotherapy
    • Psychiatry
    • Couples
    • Groups
    • COVID-19
  • About Us
    • Setting
    • Join our Team
  • FAQ
    • Resources
    • Blog
    • Music
  • Fees
  • For Clinicians
  • Contact