The at-home ketamine program, end-to-end.

Patient or referring provider submits an intake. Trellis runs a structured screen — PHQ-9, GAD-7, AUDIT, C-SSRS, cardiovascular and airway risk, support-person availability — and routes ineligible patients to in-clinic IV / Spravato or an outside referral. Nothing reaches a prescriber's queue until the screen passes.

A 60–75 minute video evaluation covers psychiatric, medical, substance-use, and trauma history. The clinician confirms diagnosis, reviews exclusions, and documents the treatment plan. Trellis enforces that consent, FDA-warning acknowledgment, and the program agreement are all captured before an Rx can be sent.

Patient nominates a sober adult — partner, family, close friend — to be physically present every session. The monitor completes ID verification, a short training, and a recorded video call. The clinician explicitly approves or rejects in Trellis. Only approved monitors can be assigned to a session.

Prescription is routed to the practice's default compounding pharmacy with NPI / DEA / PCAB / USP attributes on file. Lot number, strength, expiration, and COA URL are persisted on the patient's chart. Quantity received vs remaining is reconcilable per patient and per lot.

Two to six induction sessions, each with a live video check-in at dose, mid-session, and emergence. Vitals (HR, BP, SpO₂) are captured at defined intervals. Peer monitor attests presence; clinician reviews session and dose ladder before the next session is scheduled.

Patients move into a weekly or bi-weekly maintenance cadence. PHQ-9 / GAD-7 are collected before each session. Dose-mg and weekly-dose-count are tracked per enrollment. The clinician sees a population-level view of where each patient sits on the ladder.

Adverse events are structured (category, severity, MedWatch flag, action-taken, addressed-at) — not free-text in a note. When the arc ends, discontinuation reason is recorded on the enrollment. Reports read the cohort as a clinical population, not a list of charts.