Transcranial Magnetic Stimulation (TMS) Services

Transcranial Magnetic Stimulation (TMS) Services

To request TMS services, please complete the following form. A member of our team will be in touch within 2 business days.
Is This Patient 18 Years of Age or Older?
Please email us at TMSProgram@sagentbh.com or call 952-444-5456 to discuss TMS requirements.
Does This Patient Have Major Depressive Disorder (MDD) as a Primary Diagnosis?
Please email us at TMSProgram@sagentbh.com or call 952-444-5456 to discuss TMS requirements.
Has This Patient Tried 4 Antidepressants in the Current Episode of Depression?
Please email us at TMSProgram@sagentbh.com or call 952-444-5456 to discuss TMS requirements.
Does This Patient Have Bipolar Disorder, Schizophrenia, or Epilepsy?
If yes, patient is ineligible for TMS at this time.
Has This Patient Tried Psychotherapy?
Please email us at TMSProgram@sagentbh.com or call 952-444-5456 to discuss TMS requirements.
Does This Patient Have Metal or Medical Devices Implanted in Their Body?
This does not include dental fillings!

If yes, patient may be ineligible for TMS at this time. Please email us at TMSProgram@sagentbh.com or call 952-444-5456 to discuss TMS requirements.
Patient Name

First NameLast Name
Preferred Name
Pronouns
Date of Birth

MonthDayYear
Date
Patient Phone Number

Area CodePhone Number
Patient Email
example@example.com
Patient Address
Insurance Company Name
Is the patient a current or past client?
How did you hear about us?

Other
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