TMS Service Request

Transcranial Magnetic Stimulation (TMS) at Ellie in Minnesota

Transcranial Magnetic Stimulation (TMS) Referral Form

TMS is for patients 18 years or older, who have a Major Depressive Disorder (MDD) diagnosis, and have undergone sufficient trials of 2-4 antidepressant medications without improvement or experienced side effects and of evidence-based psychotherapy. TMS is not for patients with: Bipolar disorder, active psychosis, history of seizures or current seizure disorder, non-removable metal in the head or neck, or clients in pregnancy.
If you have questions about TMS at Ellie, contact Kayla Lindeman, 651-313-8080 (option 4)

Is this patient 18 years of age or older?
Does This Patient Have Major Depressive Disorder (MDD) as a Primary Diagnosis?
Has This Patient Tried 4 Antidepressants in the Current Episode of Depression?
Does This Patient Have Bipolar Disorder, Schizophrenia, or Epilepsy?
Has This Patient Tried Psychotherapy?
Does This Patient Have Metal or Medical Devices Implanted in Their Body?
Patient Name
Patient Name
Is this patient a current or past Ellie client?
Ellie Mental Health therapy client making a funny face

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