Ketamine-IFS Day Retreat for Psychotherapists: Application

Please fill in your information below to apply for this unique, one-day ketamine-IFS retreat. If there is space available for the date you are applying, you will be given a psycho-medical form to fill out and Keith will schedule a 15-20 minute phone call before being invited to register.

The group meets in Calliope's Bethesda office (8120 Woodmont Ave) and consists of:

30 min medical screening with Dr. Vando ($200; once medically cleared you'll pay the remaining retreat fee, below)
2 hour zoom meeting the night before, 7-9pm, introductions, intention-setting, addressing managers fears, what to expect, Q&A
Saturday: 9-10:30 - group meeting: "pre-flight" flow, centering, getting into Self
10:30-12:00: Ketamine IM journey in private room
12-1:15: Walk to nearby eatery for lunch
1:15 - 3:15: Post-KAP group processing
3:15-3:30 Break
3:30-5:00: Final group meeting; integration; how are you seeing your Self differently? Next steps
2 hour zoom meeting, 1 week post-retreat integration on the following Friday 12-2pm; what are you learning from your journey?

RETREAT COST: $1499 (+$200 medical assessment)

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

List the dates you would be interested in attending:*

Saturday, April 1st (plus 2 hrs Friday night zoom)Saturday May 1st (plus 2 hrs Friday night zoon)Other future dates to be announced

Profession Type (social worker, psychiatrist, MFT, etc.)*

List your IFS Training Experiences or Certifications*

Have you had any experience with psychedelic medicines before? If so, please list. *

Do you know colleagues who may be interested in attending and would you be willing to invite them to consider attending?*

YesNo

How interested are you in registering for the April 1st retreat?*

I would register for it today!I'm very interested but need to clear my scheduleI'm very interested but the cost is too highI would register today but have a few questions firstOther

If you answered "other" above, please explain:

Do you have any suggestions, comments, or encouragements about the proposed retreat that might help me make this event even more awesome (or at least make my day)?