If you have been approved for moving forward in the client intake process, please download the client documents below and fill them out prior to your first intake appointment.
Informed Consent – 12.27.22
Client Bill of Rights – 12.27.22
Client Information Form – 12.27.22
Client Transportation Plan – 12.27.22
Client Safety and Support Plan – 10.13.23
Client Medication and Medical/Assistive Device Form – 10.13.23
Interpreter or Client Support Person Plan – 10.13.23
Authorization to Disclose Personal Identifiable Information – 10.13.23
Notice and Opt-Out of Disclosure of De-Identified Data – 10.13.23
Client Consent for Other Individuals to Be Present During an Administration Session – 10.13.23
Client Consent for Use of Supportive Touch During Administration Session – 10.13.23
Client Consent to Receive Secondary Dose of Psilocybin Product – 10.13.23
Client Consent for Video and Audio Recording of Individual Administration Session – 10.13.23
Client Consent for Video and Audio Recording of Group Administration Session – 10.13.23