Join The Revival | Rise With Joy

Have you ever been in counseling? If yes, when & for how long?

Please elaborate as much as you would like on your counseling history below:

Do you have any physical health challenges? Please list in order of most concering to you. Be as thorough as possible in listing and elaborating on these challenges. When did they start? What was the landscape of your life, your emotions and your relationship when they started? How severe are they? What have you tried to address them? What has worked?

Are you currently on any medications for mental health or physical health? If yes, for how long? Please list below and include what each medication is treating:

Please list any vitamins and suppliments you are currently taking, including the brand:

Have you used psychedelics or entheogens in the past? If so, please share a little bit about your relationship to these plant allies. Have you microdosed with Amanita, psilocybin or LSD?

Are you currently on another microdosing protocol? If so, what is the schedule, dosage and substance? What effects have you noticed?

Do you have any allergies to medications, foods or anything else? Please describe the specific allergy and the allergic reaction:

How many hours of sleep do you get each night? Do you wake up feeling rested?

Please describe your sense of your own emotional wellbeing. Do you deal with anxiety, depression, PTSD or grief on a daily basis? What general mood do you most often find yourself in? Happy? Mellow? Tired? Sad? Distressed? Angry? Hopeful? Etc.

If you could change anything about the way you see yourself, what would it be?

What are you most interested in shifting in your life right now? Be it physical, emotional, psychological or spiritual, please describe:

Is there anything else you would like Joy to know about you and your life?

Join The Amanita Revival Circle

Join The Amanita Revival

Register Before March 17th pay

$450

$400

$450

After March 17th