Health Care Referral Form
This form is intended for use by Medical or Behavioral Health professionals who wish to refer a patient to Mindful Minds Psychiatry for Ketamine treatment.
If you are a patient who wishes to be seen at a Mindful Minds Psychiatry, please see the form that says “Patient Self Referral Form”
Referrer Contact Information
Contact Us
Parker
12760 S Stroh Ranch Way, Suite 203,
Parker, CO 80134
(720) 458-5404– Call or text.
Colorado Springs
1945 Dominion Way, Suite 110
Colorado Springs, 80918
(720) 458-5408– Call or text.
Boulder
2299 Pearl St, Suite 205
Boulder CO, 80302
(303) 848-2276 – Call or text.
Denver
3401 Quebec Street, Suite 5070
Denver, CO 80207
(720) 640-6648– Call or text.
Westminster
9101 Harlan St, Suite 250
Westminster, CO 80031
(720) 438-4363– Call or text.
Contact
Main Line: (720)-458-5413
Ketamine/Spravato Coordinator (call or text): (720) 458-5402
Fax: 720-815-0397
