Confirmation of Care

At Edelica Health we utilize a team approach and require all patients to be engaged with a mental health provider in order to undergo IV Ketamine infusion therapy.

Dear provider, Your patient has requested evaluation for Ketamine treatments. Please confirm your care of the patient. You can submit the secure form electronically, or print it out and fax it to 262-208-1405. Thank you!

Would you like us to call you prior to starting ketamine treatments?*
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​I can be reached to discuss your patient or Ketamine therapy by phone at (414) 310-7178. ​I look forward to working with you in the care of your patient. ​Kevin J. Kane, MD
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