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Facilitator Application

Welcome to the Mind Lumen Provider Community. Our Listing service is FREE!
All data is *ENCRYPTED*; in-transit and stored

Legal Notice

Disclaimer: The information presented herein is strictly confidential and is being provided to you by the organizers of Mind Lumen, (the "Organization") for information purposes only. The Organization does not make any representation or warranty, express or implied, with respect to any of the material or information contained herein. The Organization shall not assume or otherwise have any responsibility or any liability whatsoever to you or any of your affiliates or any of you or your affiliates' respective directors, officers, managers, employees or representatives resulting from the use of the information and material contained herein.

As a highly confidential and proprietary transaction, under no circumstances should you contact the targets, or their affiliated advisors, representatives or owners, without written approval from the Organization. Information provided here is supplied for educational and harm/risk reduction purposes, but is not guaranteed, to be accurate or complete. The Organization Parties are and at all times will remain the sole owners of the material and/or information contained herein. Except as required by law or regulation, you may not directly or indirectly publish, disseminate or otherwise disclose, deliver or make available to any person any of the material or information contained herein without the prior written consent of the Organization Parties.

This information herein does not constitute an offer to sell or a solicitation of an offer to buy substances.

Note: The US is a very litigious society. Our legal team is doing their job to safeguard and enable us to achieve our mission. We advocate for policies to decriminalize psychedelics for all of us so none of us should be treated as criminals for accessing and providing the tremendous therapeutic benefits of these powerful catalysts. This is not a directory service. No one can search or look you up. It is a risk-reduction navigation service (RNS). We match seekers to ethically certified providers.


Our service connects you to safe and ethical providers. Our unique Ethical Reputation Score (ERS™) and Certification program along with geo location, and most importantly, YOUR preferences determine the match.

Legal Notice
A

Law Enforcement

Are you a member of any law enforcement community or collaborate with them? - DA, Police, Sheriff, etc
Law Enforcement
A
B

What type of provider are you?

Select all that apply (maximum 4). Note: Only Clinic, Facilitator, Retreat, Therapist, Trainer, and App are currently eligible for ethics certification.
What type of provider are you?

Email

All emails must be valid email addresses to receive access. If there is a typo, emails may not be sent. As a result, correspondence will end. We want to be able to reach you but we will only contact you via email until you are authenticated into our system.

Phone Number

First Name

Please use your real name (all data is encrypted). Required for verification.

Last Name

Please use real name (all data is encrypted). Required for verification

City

State

County

Are you willing to sign the North Star Pledge?

What are you preferred pronouns?

What ethnic identity do you identify with?

On what lands do you reside? US - you can find out by following this link

Do you have an active license to provide mental health treatment?

If no license, what is your background?

Formal Training / Certification?

Have you completed any formal training/certification?
Formal Training / Certification?
A
B

What is your motivation to be a psychedelic facilitator?

How many years have you been serving as a psychedelic facilitator?

How many years have you been serving as a psychedelic facilitator?
A
B
C

Do you have a co-facilitator or facilitators?

Do you have a co-facilitator or facilitators?
A
B
C

What other mental health services / ceremonies do you provide?

What other mental health services / ceremonies do you provide?

Other Mental Health Services not listed above

Do you primarily do individual or group facilitation?

Do you primarily do individual or group facilitation?
A
B
C

How much do you typically charge per session? describe cost/therapeutic session, journey day, full session book (e.g. 2 prep + full journey day + 2 integration).

Transparency in pricing is important.

Please upload a price list if available.

How would you describe your facilitation style?

Do you have an online presence, website or social media? If so, please share.

Do you have provide a journey space?

Do you have provide a journey space?

Refer a facilitator/practitioner

Who referred you?

What are your biggest challenges and/or needs working with substances (medicine) in the community?

What services would you hope for from a platform that connects journey seekers to you?

Are there reasons you might not want to utilize such a service? If so, ideas on what would change that for you?

Any other comments, questions or resources you would like to share? Please feel free to use this space to offer feedback about the form

Privacy

Your email and phone are never listed. If you have a URL or social media presence, people can find you. If you operate above and underground, please let us know what you don't want visible. Note: We don't allow a searchable directory or listing. Your identity is not revealed to Seekers until after a match has been agreed by both sides.

Privacy Preferences

Privacy Preferences

Profile Picture

A profile picture is super helpful to make it easier to navigate seekers to you. It reduces friction in the process for those seeking help. Your safety and privacy is paramount to us. Note: We don't allow a searchable directory or listing.

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We prefer not to send emails as much so this is how we keep people informed on the latest 😊
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