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General Information
What is your level of stress?LowLowMediumMediumVery HighWhat is your level of stress?

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Gender
How sensitive are you to substances such as coffee, alcohol, drugs?

Psycho - Emotional Area

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Do you feel depressed?NeverNeverSome TimesSome TimesVery OftenDo you feel depressed?

Low

Medium

Very High

What is your level of stress?

Never

Some Times

Very Often

Do you feel depressed?

Do you feel anxiety?NeverNeverSome TimesSome TimesVery OftenDo you feel anxiety?

Never

Some Times

Very Often

Do you feel anxiety?

How would you evaluate your emotional health?PoorPoorAverageAverageVery goodHow would you evaluate your emotional health?
Do you have any addiction?
Do you have any psychological disorder? Check all that apply.

Well - Being

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How is the quality of your focus and attention?PoorPoorAverageAveragevery GoodHow is the quality of your focus and attention?

Poor

Average

Very Good

How is the quality of your focus and attention?

How is your level of energy/stamina during the day?Very LowVery LowVariableVariableVery Good and StableHow is your level of energy/stamina during the day?

very low

Variable

Very Good and Stable

How is your level of energy/stamina during the day?

How is the quality of your sex drive and Libido?Very LowVery Lowregularregularvery satisfactoryHow is the quality of your sex drive and Libido?

very low

Regular

Very Satisfactory

How is the quality of your sex drive and Libido?

How is the quality of your sleep/rest?
What kind of diet do you have? Check all that apply.

Motivation

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Poor

Average

How would you evaluate your emotional health?

Very good

We highly recommend therapeutic support as microdosing is dramatically enhanced by integration. We offer 15 min check ins and full sessions.
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Best contact number*

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Mycology psychology values curiosity. We are currently collecting feedback to help us all deepen our understanding of emerging patterns in these treatment methods. Check here if you’d like to participate in this cutting edge research.

Consultation Survey

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