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Little Amazon Kambo School Application July 2024
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Name
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Email
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Address
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Phone number
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What Dates are you interested in?
February 20-25, 2024
Future Dates
How many times have you received Kambo?
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Why do you feel called to become a Kambo Practitioner?
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Do you have any past or current health conditions?
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Are you currently taking any medication, supplements or drugs
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Do you have a history of psychosis, mania, or severe mental disorder?
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Do you have a history of heart attack or heart disease, stroke, aneurysm or embolism.
heart attack
heart disease
stroke
aneurysm
embolism
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Have you consumed Bufo/5-Meo-DMT or iboga/Ibogaine within 6 weeks before the training?
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