Esketamine (Spravato) Enrollment Request
Please answer every question in this form so our intake team can expedite your insurance authorization to allow for your appointment to be made as soon as possible.
Before you proceed, please be aware of the following clinic practices
The first appointment at Community Behavioral Health will involve an extensive biopsychosocial history obtained by a therapist followed by a psychiatric evaluation to confirm your eligibility for Spravato. You may be required to answer the same questions as the team wants to be sure we have confirmed all information in order to ensure this is the correct treatment for you.
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This form was created inside of Community Behavioral Health.