New Client Intake
Ceremonial Ketamine Program
Welcome, and thank you for your interest in working together. This questionnaire is the first step before we meet for your free consultation call. Your answers help me understand where you are, what you're hoping for, and whether the ceremonial integration coaching I offer could be a good fit for you.
A few things to know before you begin:
I am an integration coach, not a medical provider, therapist, or prescriber. I do not provide, prescribe, or administer ketamine, and I do not offer medical or psychiatric care.
To work with ketamine, you will establish a relationship with a licensed at-home or in-clinic prescriber, who will conduct their own medical screening. I'm happy to share a list of options for you to explore — the choice of provider is always yours.
My core Ceremonial Ketamine Integration Program is built around a five-session ketamine journey. We open a ceremonial container together in your preparation call, tend it through five integration calls, and close it as your journey completes. The entire program includes six zoom calls for $900.
If your chosen ketamine program includes more or fewer medicine sessions, I'll build a custom program at a rate of $150 per call.
Medicine costs are separate and paid directly to your prescriber — the most affordable at-home telehealth programs start around $450 for five sessions ($90 per medicine session).
This questionnaire is a first conversation, not a contract. If we decide to work together after your consult, I'll provide a full disclosure and coaching agreement at that time.
Your responses are held in confidence and used only to prepare for our conversation.