Thank You

1- Full Name

2- Whatsapp Number

3- Preferred Name

4- Your Nationality

5- Passport Number (required by transportation company)

6- Starting date of the retreat.

7- Do you take any prescription medication?

8- Are you taking any SSRI antidepressants or any other psychoactive medicine (ADHD medicine, anti-anxiety, etc) ?

9- Do you have any cardiovascular issues - present or past?

10- Do you have any blood pressure issues?

11- Do you have any serious problems with your health? if yes please let us know

12- Do you have history of psychosis?

13- Do you or any of your family members have history of schizophrenia?

14- Have you experienced suicidal ideation?

15- How old are you?

16- What is your gender?

17- Do you have any food allergies?
YesNo
What Kind of Allergies?

18- Do you have any food restrictions?
Vegan (vegetables, legumes)Vegetarian (vegetables, legumes, eggs)Pescatarian (vegetables, legumes, eggs, fish)Omnivore (vegetables, legumes, eggs, fish, chicken)

19- How did you find us?
—Please choose an option—Google searchAdvertisementFriends recommendationFacebookInstagramRedditWhatsApp GroupRetreat GuruYoutubePodcastOther