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Are you a candidate for ketamine therapy?

KAP Screening

Takes 1 minute • Any “Yes” = not eligible

1
Absolute Contraindications

Any single “Yes” means you are not a candidate.

1

Known allergy to ketamine/esketamine?


2

Uncontrolled high blood pressure or dangerous heart condition?


3

Active psychosis, schizophrenia, or history of hallucinations?


4

Currently pregnant, planning pregnancy, or breastfeeding?


5

History of increased intracranial pressure, brain tumor, or aneurysm?


6

Uncontrolled glaucoma or high eye pressure?


7

Active substance use (alcohol, fentanyl/opioids, ketamine misuse)?


Confidential screening