Kambo Interest Form
Thanks for your interest in doing Kambo with Soul Soil Alchemist. Please take some time to fill out this screening service so that we can make sure that Kambo is safe for you.
Once you've filled out this form, we will send you a Calendly Link to set up a short screening call.
What dates are you interested in sitting?
Have you ever worked with Kambo before?
Emergency Contact Information (Full Name, Phone Number and e-mail)
Please let us know if you...
Have ever had a stroke
Have a heart condition
Have had or will receive chemotherapy within 6 weeks of your sit
Have had an organ transplant
Are pregnant or breastfeeding
Are taking any medications
What medications are you taking?
Why are you looking to work with Kambo?
Send me a copy of my responses.
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This form was created inside of Soul Soil Alchemist.