Ready to deepen with your partner? Please fill out the form below and we’ll send you an email to get started. 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 Couples Application What is your name? * First Name Last Name What is your partner's name? * First Name Last Name Best email to contact you? * Best email to contact your partner? (optional) How long have you and your partner been together? Why do you and your partner want to join this program together? * What are your intentions and goals in this experience? What challenges are you hoping to work through? Are you or your partner currently taking any prescriptions or medications? Please list below if so. * Has any one in either one of your families ever been diagnosed with psychosis, schizophrenia, or other psychotic disorders? * If yes, please describe. Do you and your partner have any experience with psychedelics? * yes, both of us. yes, just me. yes, just my partner. no, this will be the first time for us both! If relevant and if you'd like to share here, please briefly describe your experience with psychedelics. optional 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. 🙏🏾
