Testingstuff - The Legacy Forge

First Name

Last Name

Email

Date of birth

Country

Phone/Mobile

City

Preferred Contact Method

Have you previously participated in any psychedelic experiences?

Yes

No

Please describe your previous experiences (e.g., substances used, settings, frequency).

How would you rate your level of experience?

Beginner

Intermediate

Advanced

Have you participated in any structured psychedelic programs or therapies before?

Yes

No

Please provide details about the programs or therapies you’ve participated in.

What interests you about beginning your journey with psychedelics?

Do you have any concerns or questions about starting this journey?

What are your primary intentions for joining the Psychonautics Level 1 program?

Other

Could you go a little bit more in detail on your selected intentions?

You selected: Supporting others in their journeys. Do you have prior experience in mentoring or facilitating such experiences?

Yes

No

Please provide details about your experience and qualifications.

Do you have any medical conditions we should be aware of?

Yes

No

Please provide details about your medical conditions.

Are you currently taking any medications?

Yes

No

Please list the medications and their purposes.

Have you ever been diagnosed with any mental health conditions?

Yes

No

Please provide details about the diagnosis and current status.

Do you have any allergies, particularly to plants or substances commonly used in psychedelic practices?

Yes

No

Please list those allergies.

Are you currently under the care of a healthcare professional for any ongoing treatments?

Yes

No

Please provide details about this.

Is there anything else regarding your health and wellbeing that you’d like us to know?

Which aspects of the psychedelic experience are you most interested in?

What type of other experiences are you searching for?

What type of guidance are you seeking?

One-on-one facilitation

Group sessions

Virtual guidance

Unsure, need more information

Have you undergone any psychedelic experiences recently that you wish to integrate?

Yes

No

Please provide a detailed overview of your experience.

Are you involved in any academic or professional research related to psychedelics?

Yes

No

Please provide details about your research.

How would you like to engage with our community?

You selected: Other

How much time are you willing to dedicate to community activities per month?

Less than 5 hours

5-10 hours

10-20 hours

20+ hours

Do you have any skills or expertise you’d like to offer to the community?

Are there specific areas you are interested in volunteering for?

You selected: Other

Are you interested in supporting or funding our initiatives?

Yes

No

Maybe in the future

What type of support are you considering?

Please share your thoughts on what type of support you have in mind.

Would you like to schedule a meeting to discuss support opportunities in more detail?

Yes

No

Please select your preferred method of meeting:

Virtual call

In-person meeting

Phone call

Provide your desired time and date within the next two weeks:

Do you agree to abide by our community guidelines?

Yes

No

Do you consent to receive communications regarding program updates, events, and related information?

Yes

No

Do you consent to the use of anonymized data from your participation for research and improvement purposes?

Yes

No

I give my consent so that any content (video or audio) where I am present during any program, can and may be used in any marketing capacity by The Legacy Forge subject to my approval.

I have read and agree to the Terms of service and Privacy Policy

The Legacy Forge

Discover the Path to Your True Potential