Ketamine Intake (Non-Lousiana Clients)

Service Description

A thorough evaluation and education to determine if you are a good candidate for ketamine treatment. Visit includes a comprehensive intake history, education, and psychedelic preparation. This visit is one of the prerequisites to ketamine treatment.* Upon requesting this visit you will be sent electronic forms and surveys within 1 practice business day. All forms and surveys must be completed before your intake visit. The surveys are completed on an app called Osmind. These forms and surveys required before this visit include: 1) Ketamine Client Signature Forms (link sent via email) 2) Default Intake Form — this is the demographic and medical history form (link sent via email) 3) Mental Health Surveys — found in the Osmind app (app invitation sent via text—or log into the App Store/play store to download this app. Your login for the Osmind app is the email address you provided our clinic.) *Other requirements prior to ketamine treatment, but not required to book this appointment are: 1. Relationship with a therapist to provide support around treatments--if you don't have one that's ok we have a great referral network. You can email us at star@drmaysa.com for that list. 2. Referral letter supporting your treatment from a medical provider or therapist. We have a template available online: from the home page (www.drmaysa.com) visit the tab Docs/Archives. You will find the letter there in the "New Client Documents" folder. Email this letter to Star@drmaysa.com 3. If you’re 65 years of age or older please send a copy of your medical records and any labs to Star@drmaysa.com for the doctor's review.

Cancellation Policy

CANCELLATIONS/REBOOKING To avoid a "No-Show" fee clients must cancel/reschedule at least 24 hours in advance of the visit start time by texting 929-DR-MAYSA to notifying us of the cancellation The “No Show” fee is 50% of the visit cost except for "Functional Lab Follow-ups" where it is $150. We offer one complimentary rebooking per appointment. Additional re-bookings performed by us for incur a $35 fee per occurrence. You can cancel and rebook yourself in the Wix Spaces App or by logging into our website. REFUNDS Appointments cancelled with the proper notice are eligible for refund to the original form of payment, less a 5% credit card and processing fee. Alternatively, the refund may be held in full as a credit to be used at a later time.

Contact Details

• 1772 Prytania Street, New Orleans, LA, USA

  +19293762972

  star@drmaysa.com