THERAPSIL Email Marketing -

Australia New Zealand | TheraPsil's Psilocybin Fundamentals Training Application Form

Please Note: This is a 5-Day Intensive Training to prepare Clinical Professionals to work with Psilocybin as a Therapeutic Medicine.

Email *

General Information

International Training Dates *

First Name *

Last Name *

Pronouns

Phone *

Address *

City *

Province *

Country *

Postal Code *

Professional Information and Eligibility

Designation for Eligibility *

Years working full-time in designated field *

Highest Level of Education *

Are you registered with a professional association or college?

Professional association or regulatory body

Registration number

Specializations *

Identity & Psychedelic Background

Who are you? *

Why do you want to participate in Psychedelic Psychotherapy training? *

Current interest in your patient population base? *

Personal or professional experience with psychedelics.

How did you hear about us?

Referrals

Marginalized group *

Financial Aid

TheraPsil offers limited $500 bursaries for each cohort and additional financial support based on need. Applications are reviewed weekly, with priority given to BIPOC, LGBTQ+, and marginalized applicants.

Requested Financial Aid Amount (if applicable)

Please verify your request. *