Have you been formally diagnosed with depression?
Has a healthcare professional told you that you have social anxiety disorder?
Do you experience fear or anxiety during social interactions, such as a conversation or meeting new people?
Do you experience fear or anxiety when you might be observed, such as while eating or drinking?
If yes, when did you last feel suicidal?
Feel free to leave this section blank if you did not feel suicidal.
Any previous experience with ketamine, ketamine derivatives, ECT, TMS, or vagal nerve stimulation?
Do you currently take any psychotropic medication like benzodiazepines or SSRIs such as clonazepam (Klonopin), alprazolam (Xanax), or Zoloft?