We’re honoured that you’ve chosen to take this step in your healing journey.
The process of transformation begins before you arrive. This assessment helps us determine whether iboga is appropriate and safe for you while also helping us understand how we can best support you before, during, and after your retreat.
Please answer each question honestly and thoroughly. There are no right or wrong answers. The information you provide will be treated as confidential and reviewed only by the Satori team and medical professionals involved in your screening and care.
Completion of this assessment does not guarantee acceptance into a retreat.
Family Physician or Primary Healthcare Provider
Do you currently have a family physician or primary healthcare provider?*
These questions help us understand what is bringing you to this work and what you hope to receive from your experience.
Have you previously worked with any of the following medicines or healing modalities?
Have you ever experienced a difficult or challenging reaction to a psychedelic, plant medicine, breathwork practice, or meditation retreat?*
How many hours of sleep do you usually get each night?*
How would you describe the quality of your sleep?*
Do you regularly experience insomnia, disrupted sleep, or significant daytime fatigue?
How often do you exercise or engage in physical activity?*
How would you describe your usual diet?*
Do you have any food allergies?
Do you have any food allergies?
