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Consultation Survey 

Please fill out the information below to the best of your ability. After completing the survey, you will receive a link to book your complimentary consultation with one of our practitioners.

We look forward to co-piloting this journey with you!

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Disclaimer & Diagnosis Verification​

The information provided on this website is for educational and informational purposes only and does not constitute medical, advice. We do not guarantee any specific therapeutic outcomes or results. Users assume full responsibility for any actions taken based on the content of this website and are encouraged to consult a qualified professional before making decisions related to health or wellness. We are not liable for any risks, damages, or adverse effects resulting from the use of this website.

 

By completing this form, you affirm that you are 18 years of age or older, have not been diagnosed

with Bipolar 1 disorder, Schizophrenia, experienced manic episodes or are on Lithium.

3. Gender
8. Are you currently working with a Mycology Psychology Practitioner?
9. How did you hear about us?
13. We highly recommend therapeutic support as microdosing is dramatically enhanced by integration. We offer 15 min сheck-ins and full sessions. Check all that apply.
17. Have you ever been diagnosed or suspect any of the following? Check all that apply
14. Have you ever been diagnosed with any of the following? Check all that apply

Individuals are entitled to one free consultation annually.

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