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Integrative Mental Health of the Midwest
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Insurance Accepted
Return Patient Booking
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Frequently Used Forms
Integrative Mental Health of the Midwest
Home
Services
Insurance Accepted
Return Patient Booking
New Patient Request
Frequently Used Forms
Home
Services
Insurance Accepted
Folder: Appointment Booking
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Return Patient Booking
New Patient Request
Frequently Used Forms

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Initial Ketamine Consult - Using card or alternative payment option - Cannot use insurance SARarcLooten1024.jpg
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Initial Ketamine Consult - Using card or alternative payment option - Cannot use insurance
$350.00
Follow Up Appointment- Paying with card or alternative payment options AdobeStock_1568064392.jpeg
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Follow Up Appointment- Paying with card or alternative payment options
$149.00
Initial Evaluation - Paying with card or alternative payment method image-asset.jpg
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Initial Evaluation - Paying with card or alternative payment method
$325.00
Monthly Medication Management Subscription - $65 per month AdobeStock_1434619257.jpeg
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Monthly Medication Management Subscription - $65 per month
$65.00 every month

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Disclaimer:

This form is for non-emergency appointment requests only. Do not use this form for emergencies, urgent clinical concerns, medication emergencies, or crisis situations. If you need urgent help, call 911, call or text 988, or go to the nearest emergency department.

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