this comprehensive intake form helps us prepare for our consultation & ensures we can discuss your healing journey with complete understanding. all information is held in strict confidence, & there are no right or wrong answers. please be as transparent & thorough as possible.

thank you for taking the time to complete this intake form thoughtfully. your honest responses help us ensure the safest & most supportive experience possible. we look forward to our consultation & exploring whether kambo medicine is aligned with your healing journey at this time.