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Diagnosis Current/Past placed in Assessment?
Medications placed in Medications & Allergies?
Plan
Discussed Keta guide? - Holistic approach, Ketamine treatment recommendations 3,2,1,1,1
Discussed Importance of psychiatry, lifestyle med, and counseling? 25/25/50%
Explained next steps- treatment focused therapy session, infusion specialist consult, and KIT/IMKT
Follow up meeting? Medication Management? Take over psych care or collaborate?
Discussed NPO 4hrs, No Driving 12hrs, hold opioids/benzos 6hrs before/after, arrive 15min before appointment
Discussed Spravato, data, recommendations, benefits/risk, alternative treatments (meds, TMS, ECT)
Assessment Summary and Recommendations
In Clinic Treatment Discussion
Spravato?
Spravato Treatment Discussion
First Visit to Clinic?
1st Visit Discussion
IV Treatment?
IV treatment discussion
IM Treatment?
IM Treatment Discussion
SL Treatment?
SL Treatment Discussion
Referral For Ketamine or Spravato Treatment?
PROVIDER REFERRAL FOR TREATMENT
Spravato order?
Ketamine Order?
Order Spravato Treatment for:
No Contraindications for SPRAVATO treatment
Spravato Administered under direct supervision of provider for 2 hours.
• • •
Order for Ketamine Treatment for Psychiatric disorder with rationale
No Contraindications for IV/IM/SL Ketamine Treatment
Notes
RECOMMENDATIONS
RECOMMENDATIONS
REFERRAL
Referrals
Details if needed
Now or later?
LABS
Lab Work
• • •
Details if Needed
Labs required prior to treatment?
Comments

H&P Plan Medical Form

Nurse Practitioner

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Published: Jan. 14, 2026, 1:38 p.m.
Doctor: Dr. History Physical
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