Healing Realms KAP Consultation Group Application
Our Consultation Group is an online meeting to help clinicians become more skillful and confident in working with therapeutic ketamine. It is geared toward medical and mental health professionals currently working with ketamine, as well as those who are getting ready to add ketamine services to their practices.

This group will be facilitated by Dr. Jessica Katzman, PsyD. Dr. Robert Grant, MD and Dr. Raquel Bennett, PsyD will attend alternating months, and some of the Healing Realms staff will participate and present on special topics. The content will include case presentations from participants, discussions of clinical/legal/logistical issues, and guidance/mentorship from the facilitators and participants.

We will meet online for 90 minutes per month for 6 months (see dates below). Minimum number of participants will be 4, and maximum number of participants will be 12 to ensure that everyone can participate actively.
Email address *
Name *
Degree *
Specialty *
Website address (indicate your website, if you have one)
Practice address (Street, city, state, zip code) *
Who referred you to this group? How did you hear about it? *
Are you able to independently prescribe ketamine? *
Please describe your work or your interest in therapeutic ketamine. (If you have been working with ketamine, please describe the route of administration that you prefer, your dosing strategy, and the kinds of patients that you treat.) *
What kind of training experiences did you have in therapeutic ketamine, and how did you prepare yourself to do this work? (i.e. training programs, lectures/classes, books, videos, experiential workshops, professional mentors) *
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