Please fill out the Health Assessment Below Name * First Name Last Name Do you have any experience with psychedelics? * Yes No Do you have any experience with psychedelic plant medicine in a traditional ceremony or therapy session? * Yes No Please briefly describe your experience with psychedelics. * Please list history of mental health. * depression, PTSD, anxiety, autism, etc. Self diagnosis is okay here. Are you currently taking any prescriptions or medications? Please list below if so. * Have you or has any one in your family ever been diagnosed with psychosis, schizophrenia, or other psychotic disorders? * If yes, please describe. Why are you interested in sitting in working with plant medicine? * improve mental health get deeper into flow state navigate through a difficult life event enhance creativity connect deeply with Native traditions just curious Why are you interested in sitting in this ceremony? * Please elaborate here as this helps us get to know you. We are curating this intimate group to create the safest, most aligned container for all attending. Please share anything else you would like to share with us! Please select the time(s) below that you would be able to join the group preparation session on Monday, May 8th * All times listed in CDMX local. 12:00pm 1:00 pm 2:00 pm 3:00 pm 4:00 pm 5:00 pm 6:00 pm 7:00 pm Would you like to be added to Vibrational Healing's email list (NO SPAM) to receive weekly reflections, psychedelic news, priority sign up for community events, and so much more!? Definitely! No, thank you. Thank you!
