Online Payment Options

New patient deposit

$200.00 Quantity

Full Amount for the 2nd, 3rd, 4th infusion.

This includes the initial in-person consultation.

$650.00 Quantity

Full Amount for a Booster Infusion

ONLY applicable if you have completed 4 IV infusions at our clinics, or can show proof of 4 infusions at another clinic.

$500.00 Quantity

Remaining Balance for 1st infusion

Applies only if you have paid a $200 deposit.

$450.00 Quantity

Tier 1 Pain Infusion or 2 hour Mood Infusion.

$800.00 Quantity

Tier 2 Pain Infusion - 3 hours

$1,100.00 Quantity

Tier 3 Pain Infusion - 4 hours

$1,600.00 Quantity

6 Infusion Membership - Only for existing patients who have completed 4 infusions with us (or transfers from other clinics who can show proof of 4 infusions completed).

By signing this form, you are paying for 6 infusions that do not expire and can be used at both clinics. This contract is non transferable. Should you decide to request a refund before completing 6 infusions, you can according to the following terms: each infusion received will be reassessed at $500 per infusion. Any late cancellations or no shows will result in loss of 1/2 session from your membership.

$2,550.00 Quantity

90 minute Ketamine Infusion

Applies only if you have had 4 infusion at the Ketamine Healing clinic.

$600.00 Quantity

Veteran's Discount for Initial Series Infusions (infusions #1-4)

Must show proof that you are a Veteran

$575.00 Quantity

Ketamine Booster Shot for TMS

$30.00 Quantity

Remainder Balance for Tier 3 Pain Infusion

$1,400.00 Quantity

Remainder Balance for Tier 2 Pain Infusion

$900.00 Quantity

Remainder Balance for Tier 1 Pain or 2 hr mood Infusion

$600.00 Quantity

12 Infusion Membership

Only for existing patients who have completed 4 infusions with us (or transfers from other clinics who can show proof of 4 infusions completed); By signing this form, you are paying for 6 infusions that do not expire and can be used at both clinics. This contract is non transferable. Should you decide to request a refund before completing 6 infusions, you can according to the following terms: each infusion received will be reassessed at $500 per infusion. Any late cancellations or no shows will result in loss of 1/2 session from your membership.

$4,800.00 Quantity

No-Show/Cancellation within 48 business hours Fee

$175.00 Quantity

Misc

$300.00 Quantity

Total

$0.00

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