BEGIN YOUR JOURNEY | Mushroom Goddess

ABOUT

Let's get to know each other, shall we?

Complete our questionnaire & schedule a 15 -minute phone
consultation to complete your invitation request. And good news:
this only takes a couple of minutes.

STEP 1:
Questionnaire

Basic Information

Please fill out the following form.

First name

Last name

Phone

Address

Age

Basic weight:

Medical Info

Do you currently take any supplements or prescription medication? If so, please list each one with duration of use.

Please list all daily or occasional (maintenance) medications & supplements. Please include how long you have been using each one listed. This information is crucial in determining how we will advise relative to dose strength & any potential contraindications.

Tolerance levels. What are your tolerance levels to everyday stimulants? For example, coffee, wine, caffeine, etc. What we really want to understand is how sensitive you are. High tolerance, low tolerance, etc.

Low

Normal

High

Do you have any specific mental health conditions, disabilities or health complications?

What are your intentions with our nootropics?

Please provide as much information as possible as to your calling for a nootropic.

Including your desired protocol & what you hope to achieve. For example, softening triggers, more creativity, deep trauma healing, improved flow state, etc. This information is key for us in determining the dose best suited to your needs & goals.

How did you hear about us?

If a friend referred you, tell us who so we can say thanks!

ABOUT

STEP 1: Questionnaire

Basic Information

Medical Info

What are your intentions with our nootropics?

How did you hear about us?

STEP 2: Schedule your free consultation

STEP 1:
Questionnaire

STEP 2:
Schedule your
free consultation