Plant Healing Retreats i Danmark

Name *

First

Last

Email *

Mobile number *

Gender *

Date of birth *

Country of origin

Emergency contact name *

First

Last

Contact relation *

Contact person's telephone number *

What retreat do you request to attend? *

If you wish to know the dates for upcoming retreats please let us know

In your own words, why do you wish to go on a retreat? *

Please keep it short - you will get the chance to elaborate at a later point

Have you experienced sacred plant medicine before?

Yes I have
No I have not

If yes, please elaborate:

Do you already have a special connection with any plants? *

Do you have any active diseases, recent injuries or other? *

Have you to your knowledge had COVID at some point? *

No
Yes
Not sure

If Yes or Not sure then please elaborate on how many times, how long it lasted for and any side effects you felt during or after covid.

Are you COVID vaccinated? *

Unvaccinated
Vaccinated once
Vaccinated several times

If vaccinated, please inform us of when you received the last vaccine, if you have experienced side effects and what they were

Heart health *

I understand that sacred plants medicines are know to be dangerous to ingest with a heart condition.

Please elaborate if you have anything with the heart

Any other mental disorder not listed above? *

Does any of the below run in your family? *

Bipolar disorder
Dissociative identity
Schizophrenia
Not that I am aware of

Do you have any memory issues? *

At what age is your first memory? *

How much do you remember from age 12 and under? *

If you are on any medication, please inform us of the dosage and how long you have made use of it *

I understand that some medicine contraindicate with plant medicine

Have you ever received medication to treat a psychosis?

If yes, please elaborate

Are you pregnant? *

I understand that sacred plants medicines are purgatives and dangerous to consume while pregnant.

Do you have any food allergies *

We will not serve meat or fish, but please let us know if you are vegan

Do you have any other allergies? *

Anything else we need to pay attention to?

Please let us know how you found us *

I have visited you before
From a previous guest
Found you via internet search
Social media (please share details below)
Online article (please share details below)
Other source (please share details below)

Please elaborate

Health screening with full disclosure *

I accept this health screening with full disclosure

Because some of our workshops involve the ingestion/utilization of sacred plants, we carefully screen each guest for their safety prior to attending a tour. All herbal supplements, natural medicines, and medications (prescription and over-the-counter) must be disclosed and subsequently approved for use by Deep Spirit. All herbal supplements, natural medicines, and medications (prescription and over-the-counter) cannot be taken during the course of the workshop without the express permission of our data representative. You hereby agree that all information you provide in the application is correct and current and that you have disclosed all physical and psychological conditions as well as all herbal supplements, natural medicines and medications (prescription and over-the-counter) that you are taking. You will be contacted personally by one of our staff to ensure that you are prepared for the experience. We are not a medical facility and its owners, staff, employees and agents are not licensed medical doctors, psychologists, or psychiatrists. We do not practice medicine, diagnose, cure, or treat disease or illnesses. Instead, we function as spiritual guides, teachers and door openers that offer ceremony for the purpose of spiritual communion.

Dietary and behavioral restrictions *

I accept this dietary and behavioral terms

Our workshops may involve the ingestion of sacred plants, there are certain dietary and behavioral restrictions that must be followed. You will be advised of these restrictions when you arrive at the start of the workshop. Some of our workshops may have a different set of restrictions than contained in the following paragraphs. Each specific set of restrictions should be followed according to the corresponding tour. The amount of sweets that can be consumed on workshop due to the use of sacred plants is limited. Consumption of alcohol and street drugs are not allowed at any time during the workshop. You must also abstain from alcohol consumption and the use of street drugs for seven days after your last ingestion of sacred plants. There is to be no sexual activity whatsoever between guests and/or staff during a workshop. This includes married couples and also includes masturbation. The environment demands abstinence from all sexual activity. Should you develop a sexual or romantic interest in another person, we request that you delay any physical displays or expressions of it until the workshop is over. We are not attempting to create a moral or philosophical boundary but preventing the potentially dangerous crossing of energetic fields that can result from sexual or romantic behavior while engaged in sacred shamanic ceremonies.

Medication note with full disclosure *

I have read and fully understand the medications note

For your safety our guides have a "no medications / vitamins / supplements policy" at the facility (with the exception of birth control pills). Medical studies have shown that mixing medications and some supplements, with plant medicine can be dangerous and potentially fatal. As representatives we are not licensed to give advice on prescription medications. If you are currently taking medications, please consult with your doctor before discontinuing any medications. If your doctor approves discontinuing your medications and has guided you on the weaning process then we require that most medications need to be fully stopped at least one month before the workshop begins so that your physiology can find safe balance without it. This stability period could be extended up to six months depending on the combinations and types of medications being taken.

Terms and conditions *

I accept the terms and conditions

By checking this checkbox and typing my name in the field below, I attest that I have read and understand all of the above written medical information and have openly disclosed all requested health and medical facts. I attest that the information provided above is true and complete, to the best of my knowledge. I understand that falsifying or omitting any relevant information may be grounds for denying my attendance at this and any future ceremony for which I am applying, with or without a refund, at the sole discretion of Deep Spirit, I hereby waive, release and hold Deep Spirit harmless from any and all liability or responsibility for all impact, any injuries and/or damages or claims which may occur in the event of attending a ceremony.

Thank you for cooperating! We are with you all the way so don't hold back your questions. Please put some time into preparation before your retreat to get the most out of your meeting with plant medicine as possible. Preparation details can be found on this website. We look very much forward to assist you on your journey at Deep Spirit.

Best regards Team Deep Spirit