• Medicine Journey Intake

    All information provided here is considered completely confidential and will be treated as such.
  • Medical History

  • Psychological History

  • Psychedelics, Drugs & Alcohol History

  • Personal History

  • Trauma History

  • Preferences

  • Disclaimer: Please note that I am not a doctor and am not qualified to provide health or medical related advice. Sessions are intended to support personal growth but should not be considered a substitute for psychotherapy. Working with non-ordinary states of consciousness can involve intense experiences accompanied by strong emotional and physical releases. Medicine journey work is not recommended for people with severe cardiovascular issues or hypertension, treatment-resistant psychiatric conditions, recent fractures or surgery, acute infectious diseases, epilepsy, active spiritual emergencies, and those who are pregnant. It is important to clear all intentions of medicine use with your doctor before your session.

     

    Please read and sign the following statement:

    I declare that I have read and understand the information contained above. I also declare that I have answered all questions honestly and with sufficient detail, and I have not omitted any information that I consider to be relevant.

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