Ready to begin your plant medicine journey? Please fill out the form below and we’ll send you an email to schedule a free consultation. We receive a lot of applications, but you are important to us. As a reflection of that, we will get back to you as soon as possible. Thank you for your patience with us and for offering space in which this very important work can be done. 🙏🏾 Begin Form Application Name * First Name Last Name Email * What offering are you interested in? * Please select all that apply. Consultation Microdosing Guidance Integration Private Ceremonial Experience Psychedelic Rehabilitation Private Group Ceremony Why are you interested in working with plant medicine? * Please select all that apply. improve mental health get deeper into flow state navigate through a difficult life event enhance creativity just curious Why did you choose to work with us? What are your intentions and goals in this experience? What challenges are you hoping to work through? * Do you exercise? * yes, everyday at least 3 times a week eh, sometimes! not at all Do you have a meditative practice? * yoga, meditation, journaling, etc. yes, everyday yes, but I'm not consistent. (& that's okay 🤍) not yet! Please list history of mental health. * depression, PTSD, anxiety, autism, etc. Self diagnosis is okay here. Are you currently taking any prescriptions or medications? Please list below if so. * Have you or has any one in your family ever been diagnosed with psychosis, schizophrenia, or other psychotic disorders? * If yes, please describe. Do you have any experience with psychedelics? * yes no Do you have any experience with microdosing? * yes no Please briefly describe your experience with psychedelics. * Please share anything else you would like to share with Azalea. Would you like to be added to Vibrational Healing's email list (NO SPAM) to receive weekly reflections, psychedelic news, priority sign up for community events, and so much more!? duh! 🍄 no thank you. 🙏🏾 I'm already signed up! Please confirm that you understand, agree and consent to the following by marking each box. * I have truthfully answered all of the questions in this form. I understand that Vibrational Healing is not responsible for the inappropriate use of psychedelics, nor for the consequences that could be incurred by this practice Vibrational Healing offers Indigenous healing containers supported by IFS, Somatic experience, and other holistic therapeutic practices. While some of the facilitators are licensed for psychedelic therapy and family counseling, I understand that this work is not a substitute for therapy. Thank you so much for showing interest in this incredibly important work. We are looking forward to sharing time with you and will get back to you ASAP. 🙏🏾
