TMS Interest

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TMS Interest

If you are interested in TMS or have been referred by a healthcare provider, please fill out the HIPAA compliant self-assessment below. The information you provide below, will help us determine if TMS/SPRAVATO® are feasible options for you. You will be contacted by our staff if more information is needed and, if suitable, we will schedule your comprehensive evaluation with our psychiatrist. When it comes to your TMS/SPRAVATO® evaluation with our doctor, you have a choice between an In-person or Telehealth appointment.

"*" indicates required fields

Patient Name*

First Last

Are you a new or existing patient?*

New Patient

Existing Patient

Your Email*

Patient Phone Number*

Patient Date of Birth*

Insurance

How many anti-depressants have you taken in the past?*

Have you tried any therapies?*

Yes

No

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We Accept Most Major Insurance Policies

If you don’t see your health insurance company listed, we may still be able to accommodate you. Contact us today to see what we can do for you!

Resources

Explore Advanced Treatments for Resistant Mental Health Conditions

Our specialists provide innovative treatments like TMS therapy to support patients with persistent depression and other mental health challenges. Request your consult today.

Request a TMS Consult

Call: (904) 404 7044

Fax: (904) 329-2303

8823 San Jose Blvd., Suite 209
Jacksonville, FL 32217

frontdesk@universalneurocare.com