Your Name *

First Name + Last Initial Is Perfectly Fine — No Need to Include Full Name

First Name

Last Name

Is Your Autism Diagnosis Self-Diagnosed or Diagnosed By Medical Professionals? *

Self-Diagnosed

Diagnosed by Professionals

Your Diagnoses *

(Check All That Have Been Diagnosed By Professionals)

Autism (Level 1 Support Needs)

Autism (Level 2 Support Needs)

Autism (Level 3 Support Needs)

Autism Spectrum Disorder (No Support Needs Specified)

ADHD

Alexithymia

Anxiety

Social Anxiety

CPTSD

PTSD

Depression

Bi-Polar

Borderline Personality Disorder

Schizophrenia

Aphantasia

Multiple Schlerosis

Alzheimers

Ehlers-Danlos Syndrome

Gastro-Intestinal Issues

Epilepsy

Intellectual Disability

Tourette Syndrome

Developmental Coordination Disorder

Obsessive Compulsive Disorder

Nonverbal Learning Disorder

Sensory Integration Dysfunction

Fragile X Syndrome

Intellectual Giftedness

Speech & Language Disorder

Sleep Disorder

Developmental Delays

Asperger's Syndrome

Are You Presently Taking SSRI's? *

Yes

No

Have You Ever Taken SSRI's At ANY TIME for ANY LENGTH OF TIME in your life? *

Yes

No

In your lifetime, have you ever consumed LSD? *

Yes

No

In your lifetime, have you ever consumed psilocybin? *

Yes

No

In your lifetime, have you ever consumed MDMA? *

Yes

No

In your lifetime, have you ever consumed DMT? *

Yes

No

You Live Near To... *

Harvard (Boston Area)

University of Toronto (Canada)

Colorado, USA

Oregon, USA

Jamaica

The Netherlands

None of The Above

You're Willing To Travel To... *

(Check all that apply)

Harvard (Boston Area)

University of Toronto

Colorado, USA

Oregon, USA

Jamaica

The Netherlands

None of The Above

If travel is required to participate, are you capable of paying for your own travel and lodging in order to participate in research? *

Yes

No

You Have A First-Degree Relative With A History or Diagnosis Of... *

Psychosis

Schizophrenia

Bi-Polar Disorder

None of The Above