For all new potential guests, you can join our Waitlist by completing the form below. All information is end-to-end encrypted and kept confidential. After completing, please spend some time on our website to familiarize yourself with our various offerings, lodging types, pricing, and testimonials.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Address
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Street Address
Street Address Line 2
City
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Postal / Zip Code
Date of Birth
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Age
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Profession
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Linkedin Profile or other Professional/Career Page. If no career page, please include a link to social media page
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Medical Conditions
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Medications:
Psychological Conditions
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We extend Hero Rates to those who serve, have served, and first responders. Do you have any affiliation to military, government, law enforcement?
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Yes
No
Please tell us about your experience with plant medicine. If you have no experience, simply right "No experience in the box below.
We give first priority to those referred to us by current Eden Members or referred to us by prescribers (ie: therapists psychologists, psychiatrists, medical doctors, etc). How did you learn about us?
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Which Retreat Experience are you interested in? (descriptions are on our OUR OFFERINGS page: www.TheSacredHouseOfEden.com)
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Private Retreat
Semi-Private Retreat
Couple's Retreat
Group Retreat
Upload Copy of Driver's License (for age verification purposes)
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