Intake FormFill this out when you are ready to work with Ambroz :) Name * First Name Last Name Email * Phone (###) ### #### What are the main areas you would like to work on? Mental Health Spirituality Psychedelic Integration Psychedelic Prep Expanding Consciousness Releasing Attachments Preparing for death and or grieving Do you have any experience with psychedelics? (Please give brief details) Do you have any current mental health diagnosis? (or do you consider yourself neurodivergent?) In what ways do you feel unfulfilled or lacking? What perceived challenges, problems, or hardships do you feel are blocking your progress? What attachments or addictions are you struggling with? What are some of the strengths you bring to the table during this journey? What is your relationship to spirituality? Spiritual but not religious Regularly attend church or temple Yogi for life Dabbled in Meditation I am God Expert meditator (whatever that means lol) Message * Thank you!
