Congratulations on taking this huge step towards your personal development. We're grateful for the opportunity to support you on your journey.

Please fill out the following form and someone will reach out to you for your intake appointment and payment information.

Email *

First Name *

Last Name *

Phone *

Date of birth *

What do you hope to find or obtain/gain the MOST during this journey? It is important to keep in mind that this is a process. Most people will continue on with more journeys in the future. Please do not be discouraged if you cannot access and/or address everything you seek to in one journey. *

Do you have any fears or hesitations regarding your psychedelic journey? *

In what setting would you prefer to embark on your journey?

What songs (Musicians/Title of Songs/Genres of music) are calming for you?

What helps you recenter/ground yourself? (deep-breathing, art-work, journaling, meditation, jigsaw puzzles, nature immersion, etc.). What has worked for you in the past? *

Have you ever/or do you currently meditate? If yes, explain your level and experience. *

What emotions are difficult for you to sit with? *

In what setting would you prefer to embark on your journey?

What are your triggers (if any)? How will we know when you are being triggered? If you are feeling challenged, are you comfortable with your guide holding your hand, placing a hand on your arm, or would you prefer no touch at all. Please understand that what is agreed upon BEFORE taking your dose is what your Guide will implement during your journey, if needed. *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

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