Your Safety is Our Priority
Complete our confidential medical disclosure form to ensure ayahuasca is safe for you. All information is reviewed by qualified medical professionals and kept strictly confidential.
Professional medical review • Completely confidential
Medical Screening Saves Lives
Ayahuasca is a powerful plant medicine that can interact with certain medical conditions and medications. Our thorough screening process ensures participant safety.
Cardiovascular Safety
Ayahuasca can affect heart rate and blood pressure. We screen for heart conditions, hypertension, and related medications.
Psychiatric Screening
Certain psychiatric conditions may be contraindicated. We evaluate mental health history to ensure participant safety.
Medication Interactions
Some medications (especially SSRIs, SNRIs, MAOIs) can interact dangerously with ayahuasca. Full disclosure is critical.
Critical Medication Warning
DO NOT stop prescribed medications without your doctor's approval. Abruptly stopping certain medications (especially SSRIs, SNRIs, or psychiatric medications) can be dangerous.
Always consult with your prescribing physician before making any changes to your medication regimen. Our medical screening will help determine if ayahuasca is safe given your current medications.
Medical Disclosure Form
Complete the form below to submit your medical information for professional review.
Personal Info
Medical History
Ayahuasca Experience
Emergency Contact