First Name *

Last Name *

Phone *

Email *

Have you EVER been diagnosed with or experienced any of the following?

(Check YES or NO for each)

History of stroke or transient ischemic attack (TIA) *

Yes

Seizure disorders or epilepsy *

Yes

Heart disease or heart conditions (including heart attack, arrhythmia, structural heart conditions) *

Yes

Traumatic brain injury or neurological conditions *

Yes

Severe mental health conditions (including psychosis, schizophrenia, unmanaged bipolar disorder) *

Yes

Any “Yes” response requires additional information below, including diagnosis, dates, current condition, and medical clearance if applicable.

BLOOD PRESSURE AWARENESS

(Not a Contraindication)

Do you have a history of any of the following? Please click all that apply *

High blood pressure

Low blood pressure

Fluctuating blood pressure

Normal blood pressure

Are you currently taking any blood pressure medication? *

Yes

Is your blood pressure generally stable? *

Yes

Note: Blood pressure conditions, including normal blood pressure, are not a contraindication to Kambo. This information is collected for preparation, safety, and in-session monitoring.

MENTAL & EMOTIONAL HEALTH

(For Safety, Support, and Appropriate Care.)

The questions below are asked with care and respect.

They help me understand what support is appropriate and ensure this work is approached safely and responsibly.

Have you ever been diagnosed with or experienced any of the following? Click all that apply *

If yes, please share any relevant details, including your current level of stability, support systems (medical, therapeutic, or otherwise), and how you are currently caring for your mental and emotional health: Note: These conditions do not automatically disqualify someone from working together. However, certain states may require additional support, preparation, or may indicate that a different type of care is more appropriate at this time. Our priority is safety, integrity, and respect for your nervous system and wellbeing.

The following conditions are considered non-negotiable contraindications for this work, as proceeding could pose serious risk. This boundary exists to protect your well-being and to ensure care is offered responsibly and ethically.

If any of the below apply, this does not reflect a personal failing or lack of readiness. It simply means that this particular modality may not be appropriate at this time, and other forms of support may be more suitable.

Check all that apply

History of stroke or serious heart condition

Seizure disorder or epilepsy

Severe or unstable mental health condition

I confirm that none of the above apply to me

MEDICATION DISCLOSURE

Please list all medications

including:

Psychiatric medications
Blood pressure medication
Nervous system–affecting substances

Disclosure does not automatically exclude participation but is required for safety.

List your medications here. *

Choosing Your Kambo Experience

Traditionally, Kambo is offered over three sessions.
This allows the body to work in layers rather than all at once.

The first session often opens the system.
The second goes deeper into clearing patterns and stagnation.
The third is where many people report their most noticeable shifts in energy, clarity, and resilience.

This three-session approach is known as the Kambo Trinity and can be received in one of two ways:

Three consecutive days
Once per week over three weeks

Both formats support depth. The choice depends on your schedule, capacity, and how your body integrates.

For those who are newer to Kambo or wanting a focused reset, single sessions are also available.

Private Kambo Sessions

Single Session: $333
Kambo Trinity (3 sessions): $888

Private sessions are booked Monday to Friday, with all sessions starting at 10:00am.

If a weekend session (Saturday or Sunday) is required:

Single session: $444
Kambo Trinity: $1111

A 50% non-refundable, non-transferable deposit is required at the time of booking to secure your session.

Monthly Group Kambo Sessions

I also offer monthly group Kambo ceremonies on a sliding scale of $111 to $333.

Group sessions are intentionally smaller and held with care and structure.
The full exchange amount is required at the time of booking and is non-refundable and non-transferable.

Im Interested in Booking ~ NOTE all sessions start at 10am.