Microdosing Support Groups Sign-Up

Are you ready to claim the life you want and live the life you've dreamed of? Start the new year off with Akasha’s guided Microdosing Support Groups, elevate well being, and step into activating your highest self.

If you're interested in participating in or receiving more information about Microdosing Support Groups, offered locally in Sebastopol, CA and virtually on occasion, please take a moment to fill out this form. Your information will be kept secure and confidential. We will reach out with more info soon!

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Are you 21 years of age or older? *
First and Last Name *
Email Address *
Phone Number
Location (City, State)
What is your current experience level with microdosing and/or psychedelic therapy? *
What are your intentions in Microdosing?
*
Would you be more interested in in-person group meetings in Sebastopol, CA or virtual meetings on Zoom?
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What is your main motivation for seeking guided group support for your Microdosing Journey?
We'd love to get an idea your story and what experience you could share with the group. How have psychedelic and/or plant medicines impacted and benefited your life? 
Were you referred by anyone? If yes, please let us know who referred you. If not, how did you find out about us?
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