You target a creature you can touch and force rapid evolution on them. The creature makes a CON saving throw. On a failure, the DM choses an feature of the targeted creature to evolve, this can be turning an arm into a tentacle, engorging the size of their skull, or growing an additional eye.
The effects of the evolution cause the target to gain the fear property and disadvantage ability checks and saving throws, on a success they suppress the evolution.