INFORMED CONSENT, INTENT, MEDICAL (ICIM)

Sitting in ceremony with Kambosito can be deeply healing for the mind, body, and spirit. When sitting with this sacred medicine, it is important that your physical body and mind are in right relation to receive kambo safely. The questions below are to ensure that you are in alignment at this time to receive the medicine.

If you have any concerns about whether you should participate, please connect with me before attending via email at monicahickey@outlook.com or by phone/text at 905-409-5118.

Participants must answer the following questions honestly to evaluate your ability to attend ceremony. Failure to disclose any medical condition or medication can result in unfavorable or even unsafe conditions for the participant.

CONTRAINDICATIONS - Further discussion may be needed

- Pregnant or breastfeeding women with babies under 6 months old

- Serious heart problems  (stents or arrhythmia are fine)

- Medication for very low blood pressure (high blood pressure medication is fine)

- Stroke , brain hemorrhage, aneurysms, blood clots

- People taking medication for psychological reasons (except anti-depressants) need to discuss suitability in advance.

- People undergoing chemotherapy and for 4-6 weeks afterwards

- Epilepsy (Not fully contra-indicated, just a precaution: mild epilepsy is okay, also if people are okay with potentially having a seizure if their medication gets flushed out. Epileptics will get a layered treatment, increasing the number of points one by one)

- Addison's disease

- If you are on immune-suppressants for an organ transplant.

- Kidney or gallbladder stones (it can get very painful if they move)

- People who lack the mental capacity to make a decision to take Kambo

​PLEASE NOTE:

​- Strongly advise against colonics & enemas 3 days before and after Kambo

- Strongly advise against Sweat Lodges/Temazcal 3 days BEFORE Kambô

- Do not fast 7 days before or after Kambo! This includes a juice fast. Clients should have a normal eating pattern.  You need the nutrients & electrolytes.

Please let me know if you are on or have recently

• Ingested Slimming or sleeping teas/supplements
• Taken Serotonin
• Taken 5HTP
• Taken Melatonin

It is advised to abstain from the above for 4-5 days before Kambo. Caution also if you re taking immune- suppressants for autoimmune disorders, GABA or blood thinners

OTHER JUNGLE, PLANT, AMPHIBIAN MEDICINES

- AYAHUASCA: It is perfectly safe to take Kambo before Ayahuasca ceremonies.  Further discussion needed if you have sat with Aya prior to Kambo.

- BUFO/5 MEO DMT: Kambo BEFORE planning to take Bufo Alvarius or any variation of 5 MEO is fine, but it is not safe to receive it for up to 6 weeks AFTER (it can send you off into another bufo/5 MEO experience with dangerous blood pressure drops)

- IBOGA: Please wait 3 months AFTER Iboga. (Ibogaine is a different story, Kambo can be taken a few days after Ibogaine, but please ask when in doubt and let us know how long ago you received any of these medicines).
​

Other considerations:

- MENSTRUATION: It is safe to sit with Kambo while menstruating.  If you are menstruating at the time of treatment, Kambo may cause the flow to increase for hours because it contains strong vasodilators and you might experience additional cramping if you take it within the first two days.

- ASTHMA: If you are asthmatic ensure that you have your inhaler with you. If you are Diabetic it s important to discuss your treatment in advance. (We will monitor your blood sugar levels, but you re not contraindicated)

PLEASE MAKE NOTE & AVOID:
● For your safety, avoid colonics, enemas, and liver flushes 3 days before and after Kambȏ.

● Avoid fasting/juice cleanse for 7 days prior to ceremony

● Please refrain from taking any Milk Thistle teas or supplements 1 week before your ceremony

● No alcohol 24 - 48 hours prior to ceremony

● It is important to fast 8 - 12 hours prior

○ With the exception of day-of-ceremony water-only fast under my supervision. (You may be instructed to drink 1 to 2 L of water within 30 minutes before your session begins).

○ It is important that you do not consume more than 4-6 liters of water 2 hours
before, during, or 4 hours after your session.

*** Please be aware that the list of contraindicated substances CAN include, but is not limited to, diet pills, amphetamines, MDMA or ecstasy, cocaine, ketamine, LSD, heroine, and crack. If you have been using any drugs, medical, over the counter, or street, please advise Monica asap. ***

• Alcohol , High Doses [48 HOURS / 7 DAYS]
• Alcohol, Low Doses  [12 HOURS/ 24 HOURS]
• Amphetamines Incl. Adderall and Ritalin [7 DAYS / 7 DAYS]
• Anti-Depressants and Anxiety Medication including Duloxetine/Cymbalta [Do not take morning of / 2 hours]
• Anti-Convulsants - [must discuss with facilitator if on an anti-convulsant medication]
• Anti-Epileptics CONTRAINDICATED
• Anti-Psychotics CONTRAINDICATED
• Ayahuasca & Analogues e.g. contingent that client is not on a no-salt diet. [24 hours / 24 hours]
• Benzodiazepines e.g. Valium, Diazepam [18 hours / 8 hours]
• Beta Blockers [Do not take morning of treatment / 8 Hours]
• Blood Thinners [Do not take morning of treatment / 8 Hours]
• Botox [7 days / 7 days]
• Bufo, 5-meo dmt [6 weeks / 24 hours]
• Cannabis [12hrs / 24hrs]
• Cocaine [3 days / 5 days]
• Coca Leaf [12hrs / 24hrs]
• Codeine [24 Hours / 24 Hours]
• Crack Cocaine [7 days / 7 days]
• Dexamethazone [48 Hours / 3 days]
• Ecstasy (MDMA) Molly or any other MD** [7 Days / 7 Days]
• Fentanyl CONTRAINDICATED
• GHB [7 Days / 7 Days]
• Heroin (recreational) [14 Days / 14 Days]
• Heroin Substitutes – Methadone, Buprenorphine,Naltrexone CONTRAINDICATED
• High Blood Pressure Medication [Do not take morning of treatment / 8 Hours]
• Inositol [12 Hours / 12 Hours]
• Iboga [90 days / 24 Hours]
• Ibogaine [10 days / 24 Hours]
• Ketamine [3 Days / 3 Days]
• Krokodil (Desomorphine) CONTRAINDICATED
• Letrozol (36 Hours / 24 hours)
• LSD [48 Hours / 72 Hours]
• Meth Amphetamine [30 Days / 30 Days]
• Morphine/ Oxycodone [5 Days / 5 Days]
• N-acetylcysteine (NAC) [2 Days / 1 day ]
• N, N-DMT [8 Hours / 8 Hours]
• Nitrous Oxide [12 Hours / 12 Hours]
• Ovidre [Plan around your dose. Please contact]
• Peyote San Pedro (Mescaline) [24 hours / 24 hours]
• Pink (U-47700) CONTRAINDICATED
• Psilocybin [24 hours / 24 hours]
• SPICE, Bath Salts, Mephedrone, Synthetic cannabinoids + more [For limited recreational usage, 30 days before treatment. Habitual use is contraindicated / 30 Days]
• Tramadol [48 Hours / 24 Hours]
• Vasoconstrictors (Triptans) [3 Days / 12 Hours]
• 2CB [48 Hours / 3 Days]
• Covid Vaccine or booster [30 days / 7 days]

By checking the "I Agree" box to next each substance you are confirming that you understand the time period to abstain from that particular substance both pre and post Kambo and that you understand the dangers involved should you choose to neglect the information provided to you regarding the substance guideline.

**Deposit will be deducted off your final amount

*** PLEASE REMEMBER TO click SUBMIT ONCE COMPLETED ***