Questionnaire - The Native Guides

Why Are you Here?

What date(s) are you interested in visiting? (Visit our DATES page for available dates)

What are your intentions?

What are your strengths?

What are your weaknesses?

What do you wish to achieve on this journey?

What is the profound meaning of life to you?

Why did you choose us for this process?

Where are you currently residing?

Have you ever been hospitalized or treated for mental illness or disorder in the past?

Are you diabetic or hypoglycemic? If so, please describe your condition and medication.

Have you taken any medications in the past year? Do you take them now?

Do you have heart problems? High blood pressure?

Have you drank ayahuasca before?

Name

Age

Phone

Instagram (enter "n/a" if you don't have an Instagram account)