Applying for Treatment

Thank you for taking the time to complete our application. We respect your time, honesty and privacy. It should take you between 30 to 50 minutes to complete the entire form. Please be as thorough as you can, and we will get back to you as soon as possible.

Please be aware that global COVID-19 restrictions have contributed to both the complexity and demand for our work.

Contact Us

Phone

+1 (801) 405-6823

Email

Skype

ibogaine1414