Schedule an Orientation Call

If you're ready to chat, lets get started.

First, let us know a bit about what you're planning and pick a time for us to talk. The goal of this call will be to get to know each other a little bit and to figure out how we can best support you. You should plan to spend about 15 minutes on the phone with us.
Name*
Email*
Where are you located?*
City Country
What is your preferred mode of contact?*
What number will we reach you at?*
For numbers outside of the US and Canada please select Whatsapp, Telegram, or Signal and include the country code.
What is your Skype username?*
Can we text you at this number?*
- Yes
- No
Do you already have a treatment booked?*
- Yes
- No
What is the name of the clinic/provider?*
When do you arrive at the clinic?*
Background*
Tell us a little bit about yourself, your treatment goals, and what you hope to gain through our sessions.
Service*
Pick a time this week*
The times listed are in EST (New York). Make sure to convert the time.

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Is it alright if we contact you by email in the future to let you know about upcoming retreats or other news?
- Yes
Do you want to receive call-in details and reminders about our Life After Ibogaine online / phone group meetings. These are free to attend.
- Yes