iFusion Aesthetics & iV Bar
iFusion Aesthetics & iV Bar
  • Home
  • About Us
    • iFusion
    • The Science
    • Meet our Team
  • Services
    • IV Vitamins & Hydration
    • IV Vitamin Add On's
    • IV CBD infusion
    • IV Ozone Therapy
    • Ketamine Therapy (IV/KAP)
    • KAP
    • NAD+ Therapy
    • High Dose Vitamin C
    • Vitamin Booster Injection
  • More
    • Home
    • About Us
      • iFusion
      • The Science
      • Meet our Team
    • Services
      • IV Vitamins & Hydration
      • IV Vitamin Add On's
      • IV CBD infusion
      • IV Ozone Therapy
      • Ketamine Therapy (IV/KAP)
      • KAP
      • NAD+ Therapy
      • High Dose Vitamin C
      • Vitamin Booster Injection
  • Home
  • About Us
    • iFusion
    • The Science
    • Meet our Team
  • Services
    • IV Vitamins & Hydration
    • IV Vitamin Add On's
    • IV CBD infusion
    • IV Ozone Therapy
    • Ketamine Therapy (IV/KAP)
    • KAP
    • NAD+ Therapy
    • High Dose Vitamin C
    • Vitamin Booster Injection

CLINICIAN REFERRAL IV Ketamine Therapy

Schedule Consult

Thank you for your interest in IV Ketamine Infusion Therapy. In order for iFusion Wellness and Ketamine Clinic to provide you a safe and beneficial therapy we require a Clinician Referral form and Medical History form (below) to be downloaded and sent back to iFusion Wellness and Ketamine Clinic. These forms must be sent to us either by e-mail, from clinician office, to todd@ifusiondallas.com or faxed to (972) 863-7997. Once we have received these forms we will reach out to you and set up a consultation. If you have any questions please don’t hesitate to contact us at (214) 205-1145.

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Forms

iFuson Ketamine Clinic Referral Form (pdf)

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Medical History Form (pdf)

Download

*The statements made and printed on this website have not been evaluated by the Food and Drug Administration and iFusion products and equipment are not represented to diagnose, treat, cure or prevent any disease or medical problem. Copyright © 2025 iFusion Wellness and iV Bar - All Rights Reserved.

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