Apply — The Sacred Union Experience & Ritual

About You

Your Names

Email Address

How long have you been together?

What brought you here? What is happening in your relationship right now that made you reach out?

On a scale of 1–10, how connected do you feel to your partner right now?

Medicine Experience

Have you ever experienced plant medicine or psychedelics before? If yes, what type? Share your experience briefly.

Have you had a bad experience on psychedelics? If so, what happened? Have you had any allergic or harsh reactions?

Health & Wellbeing

Have you been diagnosed with any mental illness, bipolar disorder, or similar? If so, when?

Are you currently being treated by a therapist, counselor, or doctor?

Yes No

What medications are you currently taking? Please list all, including supplements if relevant.

Do you have any allergies or known reactions we should be aware of?

Your Intentions

What does your ideal outcome look like? How will you know this experience worked?

Is there anything you are afraid of or nervous about going into this experience?

How did you hear about The Sacred Union?

Are you both equally willing and ready to participate? Or is one of you more hesitant?

Anything else you want us to know before we connect?

Your answers are held in complete confidence by Rachelle and Avi.

Begin Here.We Are Listening.