Language
English (US)
Español
Deutsch
Italiano
Anonymous worldwide survey (Psychedelic experience report database +)
(we do not collect personal data or IP addresses) Please answer as many questions as possible for most complete dataset. Data will be linked to corresponding lab tests where possible & reports published during the year! By submitting you agree for us to use the anonymous data. Thank you!
Email (required)
*
Confirmation Email
example@example.com
What sacraments are we working with today?
Strain, race, or common name
Species / Taxonomy
Psilocybe Cubensis
Panaeolus Cyanescens
Psilocybe Cyanescens
Psilocybe Azurescens
Psilocybe Aztecorum
Psilocybe Caerulescens
Psilocybe Subtropicalis
Psilocybe Neoxalapensis
Psilocybe Aztecorum
Psilocybe Natalensis
Psilocybe Mexicana
Psilcybe Banderillensis
Psilocybe Fagicola
Panaeolus Bisporus
Psilocybe Zapotecorum
None
Psilocybe Caerulipes
Psilocybe Yungensis
Psilocybe Moseri
Psilocybe Muliercula
Psilocybe Hooghangeni
Other
Other Sacrament
LSD
N,N, DMT
5-MEO-DMT
mDMA
Ketamine
Ibogaine
Hapé / Yapé
Cannabis
Mescaline
Peyote/ Cacti
Ayahuasca
None
Lions Mane
Niacin
Reshi
Cordyceps
Amanita Muscaria
4-ACO- DMT
Other
Take Photo or upload photo
Upload Photo
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload sequences
Browse Files
Drag and drop files here
Choose a file
Sequence files, .ab1, .seq, .txt, .fstfa
Cancel
of
Session Details
One-time macro
One-time micro
Microdose regimen
Other
Material Type
Fresh raw material
Dried raw material
Extract
Candy
Chocolate
Honey
Lemon Tech
Tincture
Blotter
Capsule/ pill
Raw crystal
Film
Other
Predominant Compounds
Psilocybin
Psilocin
Baeocystin
Not known
Other
Dosage (g)
In grams
Your weight
Lbs.
Gender
Male
Female
Other
Age
How old are you now?
Date Started
-
Year
-
Month
Day
Date
Date Ended
-
Year
-
Month
Day
Date
Source
Wild
Outdoor Cultivated
Indoor Cultivated
Purchased from Vendor
Other
Administration Method
Oral/ injested
Inhaled/ Combustion
Transdermal
Sublingual
Inhaled/ Vaporized
Insufflated
Other
Session Setting Points (select all that apply)
Indoor
Outdoor
Group
Solo
Nature
Sitter
Therapy Session
Clinical
Event or Concert
Talked to friends
Meditation
Music, singing or sounds
Preferred Silence
Stillness (sitting or laying down)
Movement (activities, physical energy)
Creative
Guided Intentions
Praying
Other
Years experience with this sacrament
Enter “0” if first session
Are you using an MAOI?
Yes
No
If yes to above please name the medication.
Prescriptions or MAOI type
Has this sample material been lab tested?
Yes
No
I would like to have it lab tested (please include email @ top of form)
QR Code Reader
Lab Report or Pic of COA Label
Browse Files
Drag and drop files here
Choose a file
Optional skip if none
Cancel
of
Lab analysis PCBE mg/g
Optional - Mg/g if known
If tested by MM IntroArtsLab what is the entry # or monthly research folder to link the COA?
Optional Monthly research folder or entry # - skip if none
Start Time - Time of ingestion
Hour Minutes
AM
PM
AM/PM Option
Minutes before Onset
Minutes
Minutes before Peaktime
Minutes
End Time - time completely metabolized
Hour Minutes
AM
PM
AM/PM Option
General Session Survey
Rows
Intense
Mild
None
Body High
Mind Alteration
Anxiety
Spiritual Significance
Meaningfulness
Visuals
Affects Experienced over entire session (select all that apply)
Fast onset
Slow onset
Long duration
Short duration
Anxiety
Euphoria
Visuals
Nausea
Physical Purging
Sleepiness
Alertness
Clarity & Focus
Sensuality
Introvertedness
Extravertedness
Disassociation
Oneness
Connection to nature
Heightened perception
Awakening (illumination)
Shadow side (dark night of the soul)
Eye twitch
This was a Microdose
This was a Macrodose
Sadness/ Grief
Fear
Anger
Love
Confusion
Out of body
Intense dreams
Crying
Laughing
Time or spatial shifts
Mood swings
Forgiveness
Oneness
Solidarity
Synesthesia
Other
Grade your sessions effectiveness as treatment
Rate the overall meaning to your life
1
2
3
4
5
6
7
8
9
10
Intellectual or spiritual or otherwise
Would you do it again?
Yes
No
Maybe
Other
Report Title
Name for your trip report/ story
Experience Report
Your story here!
0/1500
-Suggestions Box-
Leave a comment….
Save
Submit
Should be Empty: