T0 — Pre-Retreat Assessment (Iboga Research)
Your journey begins here.

Thank you for choosing to share this stage of your journey with us.

This questionnaire is a space for reflection, created to help us better understand your internal state before the experience that follows. We invite you to allow yourself approximately 25-30 minutes of quiet time, responding with openness and kindness toward yourself.

Important information:

  • Identity protection: Your data is pseudonymized — your name will never be stored alongside your answers.

  • Participant code: The unique code (RIB__) received from the research coordinator is the only identifier used to correlate your data.

  • Nature of the responses: There are no right or wrong answers. Your honesty throughout this process is the most valuable tool for our research.

  • Internal preparation: We hope that completing this form serves as a helpful step in your personal preparation for the retreat.

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Do you wish your responses to remain anonymous? *
Regardless of your choice, the data is used exclusively for research purposes and will not be disclosed publicly. Anonymisation means your responses will be analysed only through your participant code, with no other personal identifier.
Your full name (complete only if you chose not to be anonymous)
Leave blank if you chose the anonymous option.
Participant code (RIB__) *
Your unique code — e.g. RIB01 — received from the research coordinator.

Why it matters: This code allows us to link your responses across different time points (before retreat, after 1 month, after 6 months) without using your name or other personal data. Without it, we cannot identify that later assessments belong to the same participant, which would make it impossible to analyse your progress over time. Please keep it safe for all future completions.
A2. Age *
A3. Gender *
A4. Education level *
A5. Employment status *
A6. Romantic relationship status *
A7. Have you previously participated in a plant medicine retreat or psychedelic experience? *
B4. Over the past 2 weeks, how often have you felt nervous, anxious, or on edge? *
B5. Over the past 2 weeks, how often have you felt down, depressed, or hopeless? *
B6. Have you ever been diagnosed with an anxiety disorder? *
B7. Have you ever been diagnosed with a depressive disorder or mood disorder? *
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