The Gentle Dose Gathering Application
Apply to join our 6-week microdosing group experience.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What are your hopes for joining The Gentle Dose Gathering?
*
Have you participated in microdosing or medicine experiences before?
*
Yes
No
If yes, please briefly describe your experience and the medicines you've worked with (psilocybin, san pedro, etc.)
What are your intentions for participating in this 6-week group?
*
Do you have any health conditions or concerns we should be aware of?
Do you have any mental health conditions or family history of Bipolar or Schizophrenia
Do you take any medications? Please list if yes.
Any thing else you'd like me to know.
Submit Application
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