Medical & Medicine Screening Questionnaire
Church of the Living Monad — Sacramental Ceremony
Why this matters. The sacrament contains MAO inhibitors. Certain psychiatric medications, supplements, and substances can combine with it to cause serotonin syndrome or a hypertensive crisis — reactions that can be life-threatening. Certain psychiatric conditions can also be seriously worsened. Your complete and honest answers are essential to your safety and are a condition of participation.
Do not stop or change any prescribed medication on your own. Any medication adjustment must be planned with your prescribing physician and disclosed to our clinical staff. All information is held in confidence and reviewed by clinical staff.