A Weekend of Healing

This weekend healing retreat is a deeply transformative journey designed to support personal growth, healing, and self-discovery. Through the sacred experience of Bufo Medicine, you’ll be guided to release emotional blocks, reconnect with your true essence, and access profound insights. The retreat includes private yoga and meditation sessions tailored to your needs, helping to realign your body, mind, and spirit. You will also receive personalized lifestyle adjustments and recommendations to integrate this healing into your daily life. This is a safe, nurturing space for introspection, renewal, and lasting transformation.

Please fill out the form below.

Name

First Name

Last Name

Enter Your birth Date MM/DD/YYYY

Enter Your Birth Time

Enter Your Birth Location

Phone Number

Emergency Contact Name and Phone Number

What is your primary intention for attending this healing weekend?

Have you ever worked with plant or animal medicines (e.g., Bufo, Ayahuasca, Psilocybin)? If yes, please describe your experiences.

What do you hope to gain or release during this experience?

Are there specific areas in your life where you feel stuck or in need of clarity?

Do you have any pre-existing medical conditions (e.g., heart issues, high blood pressure, epilepsy)?

Are you currently taking any medications, including antidepressants, antipsychotics, or sleep aids? (List all medications and dosages.)

Have you been diagnosed with any mental health conditions (e.g., anxiety, depression, PTSD, bipolar disorder)?

Do you have a history of trauma? If yes, are you actively working with a therapist or other professional?

Have you ever experienced a psychotic episode or any dissociative states?

Are you pregnant, nursing, or trying to conceive?

(men n/a)

Do you have any allergies or dietary restrictions?

Do you currently practice yoga, meditation, or other forms of self-care? If so, how often?

Are you comfortable with private, one-on-one yoga and meditation sessions?

Describe your current lifestyle. Are there any habits or patterns you feel need adjustment (e.g., diet, sleep, stress management)?

Are you open to receiving lifestyle recommendations (e.g., diet changes, grounding practices, or daily routines)?

Have you participated in healing retreats or spiritual counseling before? If yes, what was your experience like?

What challenges do you face when integrating healing experiences into your daily life?

Are you willing to follow preparatory steps (e.g., dietary guidelines, journaling, or reflective practices) before the retreat?

Have you worked with Bufo Medicine before? If yes, please share details of your experience.

Do you have any fears or concerns about working with Bufo Medicine?

Are you prepared to surrender fully to the process of healing with this medicine?

Do you have any physical limitations or injuries that might affect yoga or other physical activities?

Are you able to abstain from alcohol, recreational drugs, and certain foods (to be specified) before and during the retreat?

Is there anything else you would like to share about yourself or your intentions for this weekend?

Do you consent to follow the guidance of the facilitator(s) and honor the retreat’s guidelines and safety protocols?