Pre-Retreat Questionnaire | Ghost Ranch

October 21-25, 2022

Please take your time to fill out your answers below.
Once you send in your questionnaire, Lola will respond to you with next steps within 48 hours.

Please include area/country code
Please include full name, phone, email, relationship to you, and country of residence.

Intention

(This can change, but it gives us an idea so we can begin to support your intention as soon as possible.)
If you were an animal, which one would you be? *
(There is no right or wrong answer!)

Ceremony Safety Questions

The following questions may be intense. It is not our intention to relive any traumas/pain you may have lingering or affecting you, but it helps us understand what healing modalities are safest for you. This is particularly important for participation in ceremonial plant medicine work, which sometimes has contra-indications we must consider for your safety.

We also ask these questions because you'll be working in a group during our retreat. We want to ensure a safe, healing space for all participants involved.

If you do not feel comfortable describing the associated medical detail, please write how you feel. If you'd prefer to only discuss it over the phone, then please note that in the details field.

Thank you so much for your honesty and understanding.

(Including, but not limited to: history of seizures, heart problems, blood pressure concerns, allergies, asthma, lack of mobility, chronic pain, migraines, etc.)
(e.g. food/smoking/drugs/etc.)
How are you planning to participate in our ceremony with medicinal mushrooms? *
There is no wrong answer here, and you're free to update your plans for this as we go! This just helps us plan our ceremony supplies accordingly.
What measures are you taking (physical distancing, mask wearing, hygiene measures, etc.)?

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