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Meditating

Health Form

I want to make a journey with
I declare that (if necessary in consultation with my doctor) I am prepared to abstain from alcohol, drugs, medicines, nasal sprays and/or supplements for at least three days, and in some other cases two weeks, for my own health and well-being.
Do you have high blood pressure or heart defects?
Do yu want to participte in th University of Maasticht' research?
Do you have experience with Ayahuasca or other entheogenic medicines?
I declare that I have answered this fully and truthfully.
I agree to the terms of delivery

Bedankt voor uw gezondheidsformulier.

Your data will never be provided to third parties and will be removed from our system two days after the ceremony.

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