KAP for CPTR Students Sign up formPlease fill out this form to attend our KAP experiential retreat on Nov 9th 2022 in Montague, MA Name * First Name Last Name Email * Please describe briefly if you have had any prior personal experience with Ketamine) * Have you been vaccinated and boosted against the Covid-19 virus * Yes No Have you had any of the following symptoms within the last 10 days * Fever Shortness of breath Cough Nasal Congestioni Loss of sensation of taste or smell Nausea/Vomiting/Diarrhea None of the above Thank you!
