Kambo Application
To ensure your safety in participating in a Kambo ceremony, please fill in the following intake form with radical honesty and great care. This applies to listing all medical conditions, medicines, supplements and any substances taken or being taken, as there may be contraindications that could pose a risk to your well-being and safety.

It is of the upmost importance that I understand where you are at when it comes to your current physical health and mental well-being to ensure that it is safe to administer Kambo to you at this time.

All your answers are kept confidential
.
If there are details you consider too sensitive for this form, we can discuss the details in private on our consultation call.

Once I receive and review your application, I will send you a text message to arrange a quick 25 minute consultation call. Or, once finishing this application form you can go ahead and book in a 25 minute call with me using my >> calendar link.

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