What inspired you to join this retreat? (Check all that apply)*

Do you currently practice any of the following?*

Are you currently experiencing any of the following mental health challenges? (Check all that apply)*

Have you explored or studied topics related to consciousness, such as:*

How comfortable are you with exploring altered states of consciousness through practices like meditation, breathwork, or plant medicine? (Scale: 1 = Not comfortable, 5 = Very comfortable)*

Are you comfortable participating in physical activities such as cold plunges and light exercise?*

Are you open to practices such as guided meditations, plant medicine ceremonies, and reflective journaling?*

Have you previously participated in plant medicine ceremonies?*

By submitting this form, I confirm that the information provided is accurate and truthful. I understand that this retreat involves practices, including plant medicine, that may not be suitable for everyone, and I agree to follow all guidelines provided by