Nepenthe Wellness - Sign Up Survey

Ready to start your life changing journey?

Complete the following to get pre-qualified for ketamine treatment, select your treatment plan, integration coaching and schedule your first call with our office.
Are you currently a resident of Texas?*
Currently we are only accepting patients in the state of Texas
How are you feeling? (choose all that apply)*

I feel depressedI have bipolar disorderI feel anxiousI have PTSDOther

We are sorry you've been experiencing these issues.

We are here to help!

85% of our patients see a reduction in their symptoms after just two treatments.

Continue completing this form for more information on this revolutionary treatment!

Here are some answers to frequently asked questions about ketamine treatment

How does ketamine treat mental health?

Research has shown ketamine to be highly effective in treating depression, anxiety, bipolar, PTSD, and OCD. Ketamine works by binding to various receptors in the brain to promote regrowth and connections between brain cells that help regulate one’s mood.

What are the common side effects?

The most common side effects are nausea and fatigue. We offer Zofran, a preventative anti-nausea medicine, to help offset any symptoms.

What will my dose be?

Your dose will be specific to you, it is based on your weight, comfort level and your experience with psychedelics. We may vary the dose as your treatment progresses according to your results and feedback.

Should I be concerned about any risks of addiction?

Ketamine itself has not been shown to have addictive properties. In fact, there is research to suggest that ketamine can be an effective treatment for overcoming addiction. If you have a history of substance abuse, it does not exclude you from receiving treatment. However, it’s important to disclose this to your clinician so they can develop the right treatment plan for you.

Are you currently working with a therapist?*

YesNo
Have you experienced ketamine and/or other psychedelics before?*

Yes, recreationalYes, medicalNo
Your journey is supported by certified psychedelic coaches who are trained in preparation and integration. Out of the following, which do you prefer your coach to be?*

SpiritualClinicalAnalyticalUnsure

Next, we need to collect some health data to assist us in determining if ketamine may be a good fit for you.

Ketamine isn't a great fit for some people with certain underlying conditions.

If you are in a life-threatening situation, or concerned about self-harm please call the National Suicide Prevention line at 988, dial 911 or go to the nearest emergency room. These forms are not monitored in real time by Nepenthe Wellness Center.

Please be sure to answer accurately and honestly.

Tell Us A Little About Yourself

All responses will be kept confidential and are treated as HIPAA protected information
Let's start with your name:*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you hear about us?*

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Great news! It looks like you are pre-qualified for ketamine therapy!
- Next you'll choose from a selection of packages depending on your requirements.
- You will book your call with our expert Care Coordinator who will answer any questions you have about the program, complete your paperwork, and get your Welcome Kit mailed to you.
Click Submit to be taken to the package selection page.
Unfortunately, it looks like our service may not be a good fit for you at this time based on the responses you have submitted.
- If you feel this determination has been provided in error please reach out to us at 512.986.7723 or info@nepenthewellness.com and we can discuss how this was determined.
- If you are in a life-threatening situation, call the National Suicide Prevention Line at 988, call 911, or go to the nearest emergency room.
- Responses are not monitored in real-time by Nepenthe Wellness.
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Ready to start your life changing journey?