For Patients (1)

Patient Intake Payment Form

Thank you for considering TheraPsil to assist you with your Special Access Program application, and for your dedication to making medical access to psilocybin legal for Canadians.

TheraPsil is committed to supporting patients who are seeking legal access to psilocybin through Health Canada's Special Access Program. As you may know, Health Canada currently approves patients who have been diagnosed with End-of-life distress/Terminal Illness, Treatment-Resistant Depression (TRD), or Major Depressive Disorder (MDD) that have not responded to standard treatments.

Please note that there are no guarantees of a submitted SAP application being approved by Health Canada.  

To continue our efforts and provide essential support to patients in need, TheraPsil requires a one-time non-refundable donation of $250 to access our intake system. TheraPsil operates as a non-profit organization with a small yet dedicated team who are tirelessly advocating for legal medical access to psilocybin for Canadians. Your contribution greatly assists us in maintaining our services and pursuing this mission, and we sincerely thank you for your dedication and support.

Once you've made this contribution, you will gain access to our in-depth medical intake form. Completing this form will allow us to gather the necessary information to prepare a Special Access Program application on your behalf, which you can then share with your healthcare provider. Upon completing the intake form, you will gain access to a Practitioner Directory of TheraPsil-trained therapists who can support you through the process.

Patients will require a Gmail account to access our Practitioner Directory, and to save/return to their intake form at a later date.

Please ensure you are signed in from a gmail account prior to filling out the form. 

We understand the importance of this process, and are here to advocate, serve, and support you in your journey to gain legal access to psilocybin-assisted treatment. Our team is honoured to be part of your journey.

If you have any questions or need further assistance, please do not hesitate to reach out to us at support@therapsil.ca

Thank you again for choosing TheraPsil.

Price: $ 262.50
One-time non-refundable donation of $262.5 (Taxes Included)

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