Click on each PDF Logo to download each document (1 - 3). Fill them out on your computer or device.
- Clinic Forms -
Family Health & Wellness
In order for Promise Medical to administer Ketamine Muscle Injections (KMI) we need to gather some health background information from you. After the documentation is completed we will have a consultation visit for a physical screening and to review your medical history.
Phone: 385-262-4135 (Main, textable)
801-691-1448 (Alt, not textable)
Fax 801-899-7996
Address: 861 N. 980 W
Orem, UT 84057