Application for Release and Awaken: A Sacred Medicine Journey
Thank you for taking the next step! The information you provide here is used to determine together if this journey is a good fit for you. Please take your time to reflect on each answer. If you don't hear from us within 4 business days, please contact Jaime at: or Arturo at:

Amor y luz!
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Full Name
Email address
Phone Number
(City, Country)
How did you hear about this retreat?
Why you are interested in participating in Release and Awaken?
What do you hope to gain out of participating?
What are your goals and intentions?
What is going on in your life right now that you feel working with sacred plant medicines may be of help?
What do you feel is blocking you in acheiving what you want?
Have you ever worked with ayahuasca before? If so, please describe your experience(s).
What was it like for you? What did you get out of it?
Do you have experience with any of the following?
Briefly describe your experience with the practices you checked above.
Describe your current state of health, typical diet, and lifestyle.
Do you have any medical conditions existing or pre-existing?
Are you currently taking any medications? If so, please list which ones.
Working with ayahuasca can be very intense (both challenging and rewarding). Is there anything you are concerned about regarding the intensity of the work?
Do you have any questions you would like to discuss during our call?
Is there anything else you would like us to know about you before our call?
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