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Referral Form 

Are You a Medical- or Mental Healthcare Professional with a Patient Who You Would Like to Refer for Syntonic's Intravenous Infusions or Transcranial Magnetic Stimulation?

Looking for the Client Intake Questionnaire, instead? Find it here.

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The first step of the process with Syntonic is always to ensure that the experience will be both safe, and a helpful catalyst for sustained wellbeing. 

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To refer your patient for Syntonic's Intravenous Infusion Program (with optional integration therapy) or Transcranial Magnetic Stimulation (TMS) please complete our referral form below.

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NOTE: Once submitted, a member of our clinical team will review the submission and be in contact with the referred individual within 48 hours on a weekday to discuss the next steps, including setting up an intake appointment at Syntonic, situated in Saxonwold, JHB. 

Referral Form

This information is used to ensure co-ordination between treating professionals in the best interest of each client.

Please indicate whether you are seeking to refer for TMS or Intravenous Infusions by selecting from the drop-down menu:
Does the patient currently present with one or more of the following diagnoses or mental health concerns? Please select all that apply.

This section will assist us in screening for any psychological conditions that my preclude you from safely participating in our treatment-resistant therapy programs.

This section will assist us in providing appropriate, tailored interventions, as needed.

This section will assist us in providing appropriate, tailored interventions, as needed.

+27 63 782 4975

info@syntonic.me

73 Oxford Road, Saxonwold, 2055, South Africa

All Rights Reserved. Syntonic. 2025

Syntonic_Psychiatrists, Psychologists at 73 Oxford Road, JHB
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