PATIENT INFORMATION FOR
KETAMINE STUDY
FEES ~ EFFECTIVE 12/14/07
PLANS #1 and #2
Fees should be discussed with the hospital representative before signing the CONSENT form
The following fee schedules are outdated and presented for information purposes:
PLAN # 1
From: Anthony Kirkpatrick MD, PhD [mailto:akirkpat@tampabay.rr.com]
Sent: Friday, December 14, 2007 8:02 PM
To: ________________
Cc: Cassandra Fuentes; Alejandro Torres; Fernando Cantu MD; ____________
Subject: Fees for research study
Dear ________:
Dr. Cantu and I believe it is very important that the financial obligations be spelled out in detail before you arrive in Monterrey.
As we discussed, we expect you to require more hospital care than the average research subject. When you arive by private jet ambulance, you will be admitted directly to the hospital.
It is my understanding that you will be obligated to pay a deposit of $44,000.00 US dollars. Of that amount, $35,000, will be paid directly to the hospital and $9.000.00 will be paid to Dr. Cantu to cover physician fees. You need to communicate directly with Dr. Cantu for the details on the physician fees and directly with the hospital (through Ms. Fuentes) regarding the hospital fees.
Contact information:
1. Cassandra Fuentes (Ph. 011-52-818-389-8390)
e-mail cfuentes@hsj.com.mx)
8:00 a.m. a 5:30 p.m.
Telephone: 1-866 HSJMEDI
email: info@hsj.com.mx
2. Dr. Cantu:
011 521 818 259 1023 (Cell)
Home:
011-528-18-363-2315
Anthony Kirkpatrick, MD, PhD
PLAN #2
From: Anthony Kirkpatrick MD, PhD [mailto:akirkpat@tampabay.rr.com]
Sent: Friday, December 14, 2007 8:13 PM
To: __________
Cc: ___________; Alejandro Torres; Cassandra Fuentes; Fernando Cantu MD
Subject: Fee for research study
Dear _______ :
Dr. Cantu and I believe it is very important that the financial obligations be spelled out in detail before you arrive in Monterrey.
As we discussed, we expect you to require average hospital care compared to the average research subject.
It is my understanding that you will be obligated to pay a flat fee, up front, of $32,000.00 US dollars, which will cover all hospital and physician fees. You need to communicate directly with the hospital (through Ms. Fuentes) regarding the fees.
Contact information:
1. Cassandra Fuentes (Ph. 011-52-818-389-8390)
e-mail cfuentes@hsj.com.mx)
8:00 a.m. a 5:30 p.m.
Telephone: 1-866 HSJMEDI
email: info@hsj.com.mx
2. Dr. Cantu:
011 521 818 259 1023 (Cell)
Home:
011-528-18-363-2315
Anthony Kirkpatrick, MD, PhD
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