Welcome to Crestline Health and Wellness
Ketamine therapy treatments offer relief for many patients and may provide relief for you. We recognize that choosing to move forward with these treatments can be challenging and requires a significant commitment. We look forward to working with you as partners in your care. Please contact us at any time with questions, or with comments, or for more information. Sincerely, Dr. Amy van Elkan
mail@crestlinehealthandwellness.com 205-848-2768
To register as a new patient please complete and submit the forms in this packet: - General Information – 2 pages
- Medical History – 2 pages
- Consents and Authorizations – 2 pages
- General Policies – 2 pages
- Notice of Privacy Practices – 3 pages
- Physician Referral – 1 page
If you are being treated for a mood disorder, our minimum requirement is that patients have, and list in their paperwork, a psychiatric professional who they can rely upon for their psychiatric needs.
To submit the completed forms or you may bring with you to your consultation: Mail:Crestline Health and Wellness
Shades Brook Office Building
3300 Cahaba Road, Suite 100
Birmingham, Alabama 35223
Or email: mail@crestlinehealthandwellness.com Scheduling your treatment: Contact us at any time to schedule your treatments.
