Ecuador Trip Health Waiver

The safety and health of the participants at our retreat is our highest concern. Our master plant medical guidelines exist to be sure that you begin your retreat under safe and healthy conditions.

Please read this information carefully and fill out all required information. If needed, discuss your retreat with a doctor that you trust and contact us if you have any further questions. All information shared is held with the utmost confidentiality.

Medical History

Medications and Supplements

Mental and Emotional Health

Allergies and Dietary Needs

Medical Guidelines VERY IMPORTANT

Recreational and/or pharmaceutical drugs in combination with plant medicines, or with the fasting process can be harmful and potentially deadly. It is imperative you adhere to the following guidelines. Do NOT quit any medications and treatments without checking with your doctor first.

DO NOT take the following substances for at least 14 days before the retreat:

• Recreational drugs like cocaine, meth, speed (amphetamines), crack, ketamine, XTC, GHB, etc.

• MDMA, alcohol

• Cough and cold medicine

• Sleeping pills

• Antidepressants containing SSRI’s

• Antipsychotics

• Barbiturates

• Appetite suppressants

• Medications for high blood pressure

• SSRI or MAO inhibitors (work against the processes of master plants and will not contribute to a pleasant experience.)

• Opiates

• Allergy medications or antihistamines*

• Respiratory medications for asthma*

*In severe cases please contact us. Be sure to bring any medications in case of emergency.

It is forbidden to enter the retreat combining any recreational substance, pharmaceutical drugs, that can affect the physical and psychological body in any way. Each plant must be used in its own right context, and never

be combined with other drugs, stimulants or antidepressants. There shouldn't be any chemical altering of your body or brain even if seemingly for something minor.

Disclaimer Note:

Although considered a healing process, these plant medicines are not a substitute for modern medicine. Plant medicines should be considered complimentary to other medical treatments you are currently on. Consult your doctor on a safe time limit for you to be off any medications. Follow your doctor’s advice in combination with ours.

Diabetes

You are required to let us know ahead of time so we can make sure we prepare a special diet and you are safe. Please let us know that you are a diabetic and might need special care. We want to make sure we are there for you if you need staff assistance.

Agreements

I will discontinue all use of alcohol, recreational/street drugs and non-prescribed pharmaceuticals at least 2 weeks prior to coming to the retreat. I understand that these are strongly contraindicated with the retreat and can be very dangerous and potentially fatal when combined. I will check with my doctor before stopping taking any medication.

I understand by participating in this trip that there are inherent risks. I agree to take full responsibility for my decision to attend and agree to hold harmless facilitators, organizers and associated parties.

I understand that trip insurance, including medical coverage, while not required is encouraged. In the unlikely case that medical expenses are incurred, I agree to take full responsibility for my decision to have or not have medical insurance coverage.

I have completed this questionnaire myself, have answered truthfully, and understand that withholding or misrepresenting any information could result in serious complications when taking part in this retreat.

I have read, understand and will comply with these medical guidelines and general policy.