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Request and Referrals Information

At Luminous Health, we operate on a referral-only basis for our services.

Healthcare professionals looking to refer a patient should select the “Referring a Patient” option.
Counselors and psychiatrists from rehab centers who want to explore a partnership with us in offering Ketamine Treatment can choose “Interested in Collaborative Program.”
Individuals seeking Ketamine treatments must have a referral from a healthcare provider. If you’re interested, you can select “I am an Individual who would like more Information” to receive an informative email that you can then forward to your healthcare provider for a referral.

Reason for Inquiry(Required)

Referring a Patient

Interested in Collaborative Program

I am an Individual who would like more Information.

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Preferred method of communication

Telephone

E-Mail

Patient Name(Required)

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Patient Email(Required)

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Patient Age(Required)

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