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 minutes to 50 minutes to complete the whole form. Please be as thorough as you can, and we will get back to you as soon as possible.

Unfortunately due to COVID-19, we are currently not accepting clients for treatment.

Contact Us

Phone

+1 (801) 405-6823

Email

Skype

ibogaine1414