JHO Retreat/Ceremony Application 
Complete this form to apply to attend our 2025 - 2026 retreats. AFTER YOUR APPLICATION IS SUBMITTED, PLEASE CHECK YOUR EMAIL (AND SPAM) FOR AN IMMEDIATE FOLLOW UP EMAIL.  You will receive a registration link and have the opportunity to set up a 15-minute call to speak with one the facilitators.

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Email *
Please enter your first and last name *
Email address *
Which Retreat/Ceremony are you applying for? *
  Have you ever been clinically diagnosed with or experienced symptoms of any mental health conditions (e.g., schizophrenia, bipolar disorder, severe anxiety, or depression, panic attacks, psychosis etc)? If yes, please provide details.   *
Do you have any preexisting medical conditions? (Heart issues, high blood pressure, recent surgeries, pregnancy or recent loss/termination of pregnancy, epilepsy, seizures etc?) *
Are you currently taking any prescription based medications? If yes, list the condition that you take medication for? *
  What is your current emotional and mental state? "Normal" is not an appropriate answer as we have no clue what your norm is. Please be as detailed as possible about what is happening in your inner world. Are you experiencing any major life stressors, trauma, or instability at this time?   *
  Have you worked with sacred medicines, plant medicine, or other substances that cause altered states of consciousness before? (marijuana, mushrooms, ayahuasca, hape, bufo, kambo, peyote, iboga, lsd, mdma/molly etc) If so, which substances?  *
  Why do you feel called to attend this retreat? What is your intention for this experience?   *
What is your age? *
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