Healing Jungle Retreat with Dona Otilia
Your health and safety are our top priority and we take them very seriously, therefore, our application process is thorough and asks you to share some personal and private information. We ask that all questions are answered with utmost honesty and transparency. The reason we do this is to ensure that our recommendations and those of our healer are correct, and safe, for you. All information shared is completely confidential. After submitting your application, it will be reviewed carefully and will be followed by an in person meeting or video chat with the organizers of the retreat. Once the interview is complete and we feel you're a good fit for the retreat we will request a non-refundable $500 deposit payment from you to secure your spot by November 22nd 2023.  The remainder will be due December 22nd 2023.

***If for whatever unforeseen reason Dona Otilia or the hosts need to cancel the event you will be refunded 100%***

Thank you for taking the time, thought, courage and energy in devoting yourself to this process. By actively participating and committing to this process you aid us, and the medicine in serving your needs and intentions.
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Email *
Please be sure to read the Medicine Experience on the previous page before filling out this application. *
Required
Name *
Gender *
Emergency Contact (Name, Phone number, and E-mail) *
Date of Birth *
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Have You Worked with Ayahuasca before? *
Are you willing to commit to the preparation process & diet made by the facilitator of the retreat? *
Preparation process and diet begins at least 14 days before the retreat starts and includes discontinuing the use of alcohol, recreational drugs, and follows a course of mental emotional spiritual preparation.  The diet includes lowering intake of salt, sugar, spices, dairy, oil, fermented foods, herbs, prescriptions, caffeine, pork, processed food, sex of any kind including masturbation, and social media or media consumption.  Prescription medications may also have to be discontinued prior to your participation - please check with Nicole & Joshua about your specific prescription(s).
Please share your healing intentions and why you are interested in working with plant medicines. *
Have you had any experience with visionary plant medicines, or psychedelics? Please explain. *
Please share your past history, and any spiritual / religious background. *
Have you experienced adverse or particularly difficult experiences with other psychoactive substances that you have found hard to integrate? Please explain. *
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