Amber Kerby, MS, LMFT
Contact me via email at firstname.lastname@example.org to schedule an appointment.
Once you schedule an appointment, please create a Client Portal to access all of the required forms:
This website is HIPAA-compliant and accepts a digital signature.
All forms must be completed before the initial meeting.
REFERRAL FORMS FOR KETAMINE ASSISTED PSYCHOTHERAPY (KAP)
If you are a provider and are referring a current patient: Referral Form from Provider
If you do not have a provider and are referring yourself: Referral Form from Self
Wellmark Blue Cross Blue Shield
Anthem Blue Cross Blue Shield
For all other insurance plans, I can assist you in accessing out-of-network benefits. Please contact me for more information.