Retreat Application
There are no right or wrong answers, please answer honestly 🤍
What's your first and last name?
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Email address, please!
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Phone
Tell me a little about yourself and what's calling you to a retreat
*
Which retreat(s) are you interested in?
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Select an option
Have you ever had a psychedelic experience?
Select an option
How did you hear about these retreats?
Select an option
Please list any current medications. I’m not being nosy 🤍 This just helps me understand where you’re at and make sure psychedelics are safe for you. If you’re not comfortable sharing this here, that’s completely okay. We’ll discuss it privately before any booking is confirmed.
On a scale of 1-10, how ready are you to make a change?!
1 - Not Ready
2
3
4
5
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7
8
9
10 - Full Ready
If you’re invited to join, are you prepared to make an investment in yourself if this feels like the right fit?
Select an option
Is anyone else involved in making this financial decision with you?
Select an option
Are there any other things you think that I should know about you, or any other major questions that you have about this experience?
Submit
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