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Operation Field Trip
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Operation Field Trip

What is Operation Field Trip?

Operation Field Trip is a healing mission-by veterans, for veterans and first responders. In partnership with Take A Knee Foundation, we provide medically assisted ketamine therapy combined with integrative counseling to support those battling PTSD, depression, and anxiety.

Why Ketamine-Assisted Therapy?

Ketamine therapy, when paired with guided integration support, has shown rapid and lasting relief for individuals suffering from trauma-related mental health conditions. For many, it’s a lifeline when nothing else has worked.

The Cost of Healing

Each treatment-including ketamine administration and therapeutic integration-costs approximately $625.
We recommend a series of 6 treatments, totaling $3,750 per participant.

Your support helps fund this life-changing care for those who’ve served and sacrificed.

How you can help:

  • Sponsor a veteran or first responder
  • Share this mission with your community
  • Donate to support treatment scholarships

When making a donation, please input “Operation Field Trip” in the “Transaction Reason” form box.


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Application

    Background

    Applicant Name:*

    Date of Birth:*

    Type of Service:*

    U.S. Air ForceU.S. ArmyU.S. Coast GuardU.S. Marine CorpsU.S. NavyU.S. National Guard/ReservesPoliceFireEMT

    Served In: (if applicable)

    OIF (Operation Iraqi Freedom)OEF (Operation Enduring Freedom)OND (Operation New Dawn)Vietnam

    Status:*

    RetiredMedically RetiredMedically DischargedDischargedReserveActive DutyEmployedUnemployed

    Status for Submitted VA Compensation Claim:

    ApprovedDeclinedUnknown

    Personal Information

    Marital Status:*

    SingleMarriedSeparatedDivorceWidowed

    Ethnicity:*

    African American or BlackHispanic or LatinoMulti-ethicUnknown/UnreportedWhite

    Home Address:*

    City:*

    State:*

    County:*

    Zipcode:*

    Spouse's Name (if married):

    Did your spouse serve?

    MilitaryFirst Responder

    Home Phone Number:*

    Cell Phone Number:

    Email Address:*

    Emergency Contact Information

    Emergency Contact Name:*

    Emergency Contact Address:*

    Emergency Contact City:*

    Emergency Contact State:*

    Emergency Contact Zip Code:*

    Emergency Contact Email:*

    Emergency Contact Home Phone:*

    Emergency Contact Cell Phone:

    Relationship to Applicant:*

    By checking the following box, you acknowledge completion and understanding of each step and process by which shall operate.

    Yes, I acknowledge.

    I served in the military or am a first responder (or both).

    By checking the following box, you agree to use your E-signature in place of a physical signature, and that your E-signature will stand as your legal signature in any and all respects of the law.*

    I agree to use my E-signature

    *Additional Documents (Total documents cannot exceed more than 24MB)

    DD214 (Veterans Only)

    VA Ratings Breakdown (Veterans Only)

    *Picture ID (Required for Veterans & First Responders)

    Medical Documents (Veterans & First Responders)

    Upon completion you will be contacted by medical staff for further instructions.

    E-Signature*:

    Date*:

    Security Answer - Please Verify*

    *Additional Documents

    *VERY IMPORTANT OPSEC Guidelines:

    In order for us to process your application, we may need the following documents:

    DD214:
    These are the documents you have received from the Department of Defense or the Veterans Administration. If you have been discharged from service please provide your DD214 that shows category of discharge as well. If you are still on active duty, a scanned copy of your Military ID will suffice.

    VA Ratings Breakdown:
    Your disability rating should be broken down by category of service connected injuries. Not simply a page that shows what your overall rating is. We need to know what your rating(s) is/are in order to best determine how to assist.

    Picture ID:
    This can be either a copy of your Military ID, Driver’s License, VA Card, Etc.

    Please provide us with accurate information about yourself so that we can get the assistance you requested to you as soon as possible!
    As with all documents of a secure nature, please mark out your social security number, driver’s license number, etc.

    WARNING: If you do not provide us with your complete documentation as requested, we will not be able to accept your application!

     

    Privacy Note: If you complete this form and share your personally identifying information with Combat Veterans to Careers, we may use your contact information to send further information about our organization or to contact you if necessary. We do not share your information with third parties.

     

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