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6 Week Microdosing Program
I appreciate your interest in the 6 week microdosing program. Please complete the application form below. I will reach out to you by email soon.
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Last Name
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Birthdate
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What are your intentions and reasons for seeking microdosing support?
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Do you have any previous experience with microdosing?
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Are you currently in therapy or involved in any type of support group?
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Have you received a diagnosis for any mental or physical health conditions? If so, please provide details, including the approximate date of diagnosis.
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Are you presently using any prescription medications? If so, kindly list each medication along with its dosage.
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