For Clinicians | Lucid Therapeutics

Let’s start with your patients information

We are happy to meet your patients and help them heal throughout psychedelic-assisted therapy program. Please submit their information in the referral form below and we will reach out to them.

First name*

Last name*

Date of Birth

Phone Number

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Referring Practitioner Information

We are happy to meet your patients and help them heal throughout psychedelic-assisted therapy program. Please submit their information in the referral form below and we will reach out to them.

First name*

Last name*

Phone Number

Practice Name

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Reason for Referral

We are happy to meet your patients and help them heal throughout psychedelic-assisted therapy program. Please submit their information in the referral form below and we will reach out to them.

Please share pertinent clinical information: diagnosis, treatment history & indication.

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