Personal questionnaire Filling out the questionnaire will take approximately 15-20 minutes Relationship & Family Do you have siblings? If yes, please state their gender and age How would you describe your relationship with your siblings? Can you share something about your own birth? Is there anyone in your family who is affected by mental health challenges? YesNo Were there any significant experiences, losses, or traumas in your childhood—such as death, divorce, or other impactful events? How would you describe your relationship with your mother? How would you describe your relationship with your dad? Were there other important people in your life (grandparents, teachers, mentors)? JaNein Do you have friends who are close to you? YesNo Medical Health Are you currently taking birth control? YesNo Have you ever used psychedelic medicine? YesNo Lifestyle Habits Do you consume any stimulants or substances (e.g., marijuana, alcohol, or others)? YesNo Do you have any experience with other drugs? YesNo Do you smoke? YesNo What kind of diet do you follow? (Plant-based/Vegan, Vegetarian, Mixed diet)? How would you describe your sleep patterns? (Falling asleep, staying asleep, waking up) Do you take any dietary supplements? If yes, which ones? Do you find it difficult to include regular physical activity in your daily routine? YesNo What types of physical activities or sports do you currently practice, and how many hours per week? What gives you strength or nourishes you? What do you enjoy doing in your free time? I understand that my information will be processed confidentially in accordance with the Privacy Policy. I confirm the general terms and conditions. Bitte lasse dieses Feld leer.
