Please review the following forms, provided by the Oregon Health Authority, to better understand information you may cover with Becca, your licensed facilitator, during a preparation session. An individual accessing psilocybin services in Oregon is referred to as a client.  

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Informed Consent - Updated 1.1.25

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Client Bill of Rights - Updated 1.1.25

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Client Information Form - Updated 1.1.25

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Client Transportation Plan - Updated 12.27.22

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Client Safety and Support Plan - Updated 1.1.25

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Client Medication and Medical/Assistive Device Form - Updated 1.1.25

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Interpreter or Client Support Person Plan - Updated 1.1.25

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303 Client Data Form - Updated 1.1.25

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Authorization to Disclose Personal Identifiable Information - Updated 1.1.25

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Notice and Opt-Out of Disclosure of De-Identified Data - Updated 1.1.25

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Client Consent for Other Individuals to Be Present During an Administration Session - Updated 1.1.25

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Client Consent for Use of Supportive Touch During Administration Session  - Updated 1.1.25

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Psilocybin Product and End of Session Form - Updated 1.1.25

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Client Consent for Video and Audio Recording of Individual Administration Session - Updated 1.1.25

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Client Consent for Video and Audio Recording of Group Administration Session - Updated 1.1.25