Provider Referral

Provider Referral Form

Revitalizing Infusion Therapies accepts patients age 16 and older suffering from mood disorders for counseling, med management, and ketamine treatments. For Spravato (Esketamine), insurance requires patients to be at least 18 years old with treatment resistant depression or major depressive disorder with suicidal ideation.

Referring For: (Select All That Apply)(Required)
Call Us
Free Consult