Your details are kept strictly conﬁdential and are only used by the Companionship for contacting you about your session or after-care support.
The session organizer should receive this form as part of your registration. We cannot conﬁrm your place at the session until you have completed this form (see below).
Information about the Session
Ayahuasca sessions are intended to be a personal growth experience. Working with ayahuasca can involve intense experiences accompanied by strong emotional and physical releases. It is not recommended for people with serious cardiovascular problems, serious hypertension, severe psychiatric conditions (check with your facilitator), recent fractures or surgery, acute infectious diseases, or spiritual emergencies.
If you have any doubt as to whether you should participate in the session you may want to consult your doctor or therapist as well as the organizers of the session.
Please answer all questions as fully as possible. Your answers are intended to help facilitators and are strictly conﬁdential.