Refer Your Patient

TheraPsil has a growing network of TheraPsil Associate Prescribers (Doctors & Nurse Practitioners) able to oversee patients receiving access to medical MDMA and psilocybin-assisted psychotherapy via the Special Access Program.

Each patient must first have a preliminary medical assessment completed by their community prescriber to see whether they are a potential candidate for MDMA or psilocybin-assisted psychotherapy before a referral is requested.

Download our Patient Inclusion Criteria (PIC) forms for psilocybin or MDMA below to complete with your patient.

• Patient Inclusion Criteria Forms
  • Psilocybin
  • MDMA

Confirm your patient has visited our Patients Page and has completed the following steps:

Step 1 - Read TheraPsil’s Considerations for Psychedelics and FAQ
Step 2 - Understand Costs
Step 3 - Fill out TheraPsil’s Patient Intake Form

If your patient requires assistance, please support them by completing the above steps together.

Have a question? Book a call with one of our team members

Once your patient has completed TheraPsil's Patient Intake Form, they will receive a completed, ready-to-use Special Access Program form. They will also gain access to TheraPsil's Directory, where they can connect with a treatment team ready to support their referral.