TMS Candidacy Assessment

This brief assessment helps determine if TMS therapy might be right for you.

Have you tried antidepressant medications for your current episode?

No, I have not tried any antidepressants

Yes, I have tried 1 antidepressant

Yes, I have tried 2 antidepressants

Yes, I have tried 3 or more antidepressants

How long have you been experiencing symptoms of depression?

Less than 1 month

1-3 months

3-6 months

More than 6 months

How would you rate the severity of your depression symptoms?

Mild - minimal impact on daily activities

Moderate - some impact on daily activities

Severe - significant impact on daily activities

Very severe - unable to function normally

Do you experience any of the following symptoms? (Select the one that best describes you)

None of the below symptoms

Sleep problems, appetite changes, or fatigue

Loss of interest, difficulty concentrating, feelings of worthlessness

Thoughts of self-harm or suicide

Have you experienced side effects from antidepressant medications?

I have not taken antidepressant medications

No significant side effects

Some bothersome side effects

Severe or intolerable side effects

How much do your symptoms interfere with your work, relationships, or daily activities?

Minimal interference

Some interference but manageable

Significant interference

Severe interference - unable to function

Contact Information

Please provide your contact details so we can discuss your assessment results and next steps.

Full Name *

Email Address *

Phone Number *

Primary Condition *

Additional Message (Optional)

I understand that I will receive emails and calls from the Karma team after submitting this form. My data will be used for communication purposes only. *

This assessment takes approximately 3-5 minutes to complete.

Your responses are confidential and will help us provide personalized recommendations.

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