Higher Love Microdosing Program: Intake Form

*Please note that sign-ups have closed for the April cohort. Any application you submit now will be for our next cohort, starting in August or September. 

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Ahoy, voyager of the microdosing realms! Buckle your seatbelts and get ready for a beautiful 12 week journey that will blow open your mind and heart, and rumor has it, may even make your butt look nicer, too.

We know that filling out forms is everybody's absolute favorite thing in the world. You're welcome for this opportunity! But truly, we deeply value what you share with us as we prepare to enter this 12 week portal of loving growth together.

For all of these questions, go into the level of detail that feels appropriate to you. If you feel you are straining yourself to fill this out, try and simplify. If you'd like to tell your whole life story, that's fine too.


Note: You are applying to join Cohort #2, which will be Starting in August or September of 2024

If you have any questions, you may reach out to higherlovellc@gmail.com


*All questions with a red asterisk are mandatory.


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Email *
Full Name *
Phone Number *
Date of Birth *
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What city are you located in? *
Emergency Contact Name *
Emergency Contact Phone Number *
Relationship to Emergency Contact *
How did you hear about Higher Love?  *
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