Embody the Goddess Retreat, Peru

Pay in Full Application

First name

Last name

Email

Phone

Please answer fully and honestly. Your information is kept safely and privately; this is to assess your readiness and ability to attend.

What do you desire most to get out of a week like this, and what excites you most about this retreat?

What is the greatest challenge you are currently experiencing?

Have you done women's work before? Have you done womb work or clearings? What draws you to this work?

Have you sat with Psilocybin before? If yes, please provide the date that you last sat. Was it ceremonial or recreational?

Why are you interested or what are your intentions in sitting with Psilocybin?

Are you currently taking any prescription medication, diet or sleep aids, herbs or recreational drugs? **It is your responsibility to inform me if this information changes in the coming months leading up to the retreat.

Do you have any previous health issues, surgeries or injuries?

Have you experienced any psychological health issues, bipolar, nervous breakdown, psychosis, etc.?

Do you have any allergies? Do you have any food allergies, sensitivities or aversions?

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Embody the Goddess Retreat, Peru

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