Expression of Interest in Psychedelic Treatment

Expression of Interest in Psychedelic Treatment
MDMA-assisted therapy and psilocybin-assisted therapy are now available in Australia under strict controls. MDMA-AT can be used for the treatment of PTSD and psilocybin-AT can be used for treatment-resistant depression.

Delivery of these treatments is restricted to psychiatrists who have received approval from the Therapeutic Goods Administration (TGA) as part of their Authorised Prescriber (AP) program.

Availability is currently limited as this program is in its infancy. Please fill out the form below if you are interested in being kept up to date as the field develops. Please note: filling this form does not guarantee treatment for any condition.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Location

Street Address Line 2

CityState / Province

Postal / Zip Code
What condition(s) are you currently diagnosed with?*

Treatment-Resistant DepressionDepressionAnxietyPost-Traumatic Stress Disorder (PTSD)No diagnosisOther
If you selected other, please specify:
Why do you believe you qualify for this treatment?*
Do you currently have a psychiatrist?*

YesYes, but I would like to find anotherNo
Do you have private health insurance?

YesNo
Who is your health insurer?

Medibank PrivateBUPAHCFNIBHBFAustralian UnityDefence HealthI would prefer not to discloseOther
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