Kambo Ceremony ✨

✨ Kambo Ceremony ✨

with Tribal Detox Certified Kambo Practitioner Madeline June Bauman
Kambo is a traditional Amazonian medicine that involves applying the peptide-rich secretion of the Phyllomedusa bicolor frog onto small burn points (gates) on the skin. It is a non-psychoactive substance and is used by various cultures in healing practices. It is reported by participants as cleansing, revitalizing, and healing.

Madeline sources Kambo from the Cocama tribe, who are guardians of a protected part of the Peruvian Amazon, where frogs are ethically safeguarded, and their secretions are sustainably collected in a way that does not harm them nor the integrity of the species. Madeline's Kambo organization, Tribal Detox, purchases directly from the Cocama which helps to support their people and their village.

Offerings during ceremony can include Hapé (alkaline ash and tobacco snuff) and Sananga (alkaloid-rich Tabernaemontana undulata eye drops). All of the medicines Madeline offers have a wide range of effects, often described as spiritually connective, which can range from difficult to pleasurable. Madeline may offer sound healing as a part of real-time integration of the medicines.
The data you provide in this form will be completely confidential, except for in the case of an emergency where it must be shared with health care professionals and/or your emergency contact.*

I understand.
Full Legal Name*

First NameMiddle NameLast Name
Preferred Name, Pronouns
Age*
Email*
Phone Number*
Emergency Contact Name*
Person MUST be reachable during our scheduled ceremony time.
Emergency Contact Phone*
Which are you interested in? If group, please have your other participants complete this form.*

1:1Group
If group, please name the others who are participating in your group.
Madeline is trained as a Wilderness First Responder, but she is not a medical professional. Madeline has been trained and certified by Tribal Detox LLC to administer Kambo in consideration of the following contraindications and safety measures.*

I understand.
By selecting "I agree" below, you are agreeing to disclose your health history and current medications as accurately as possible.*

I agree
To Avoid Before Kambo:
Mixing Kambo with any of the following could be extremely dangerous or deadly.
- Immune suppressants for autoimmune disorders
- Slimming or sleeping supplements (including melatonin)
- Alcohol or drugs 24 hours before and after
- Fasting longer than 18 hours within 7 days before or after Kambo. This includes juice fast. One should have a normal eating pattern leading up to and following Kambo.
- Sweat lodges, colonics, enemas, liver flushes or any water based detox within 3 days before OR AFTER using Kambo
By selecting "I understand" below, you agree that you have read the above regarding what should be avoided before and after Kambo and that you understand the dangers involved should you choose to neglect the above information.*

I understand.
Contraindication Agreement

Clients must NOT participate in Kambo Ceremony if ANY of the following apply. Please discuss any uncertainty or specific circumstances with Madeline.
By checking each box, you confirm you DO NOT have these conditions or circumstances:*

Heart problemsHistory of stroke, brain hemorrhage, aneurism, or blood clotsTake diuretic medicationTake low blood pressure medicationsPregnant or breastfeedingTake Anti-ConvulsantsEpilepsyEhlers Danlos or Marfan syndromeAddison's DiseaseAre on a no-salt diet (Ayahuasca diet)Consumed other plant medicines within 24 hours (Ayahuasca, San Pedro, Mushrooms)Have fasted longer than 18 hoursSerious mental health issues (excluding depression, PTSD, and anxiety)Have undergone or will undergo chemotherapy, radiotherapy, or immunotherapy (within 6 months)Taken immune-suppressants for organ transplantAre recovering from major surgeryHave had a COVID-19 vaccine within the last monthAre under 18 years oldAre over 70 years oldLack the mental capacity to consent
Medical History Disclosure
Please share ANY and ALL of your relevant medical history, recent or current medications, and health conditions. PLEASE INCLUDE: any experiences fainting, history of seizures, or heart related events. Please overshare rather than undershare. *
Please share about any and all past experiences with Kambo. Include: Date, number of points/location on your body, preparation, experience, and results. Also share experience levels with Hapé and Sananga.*
Please share your intention for working with Kambo (and Hapé & Sananga).*
Do you have any dietary restrictions?*
Substance Guidelines

The following substances should be abstained from for a period of time before and after a Kambo Ceremony, or are contraindicated. Some of the below substances are listed in efforts of Harm Reduction. Please discuss ALL of your medications and substance use with Madeline.
By checking each box, you agree to each ABSTINENCE period: Before / After Ceremony.*

Water: 8 hours / 0 hoursBeta Blockers: Do not take morning of Kambo / 8 hoursBlood Thinners: Do not take morning of Kambo / 8 HoursBlood pressure medication: Do not take morning of treatment / 8 hoursCOVID-19 Vaccine or Booster: 30 days / 7 daysAlcohol (High Doses): 14 days / 14 daysAlcohol (Low Doses): 7 days / 7 daysCannabis: 12 hours / 24 hoursEcstacy (MDMA/Molly): 7 days / 7 daysBufo: 6 weeks / 6 weeksN-DMT: 8 hours / 8 hoursIboga: 90 days / 24 hoursIbogaine: 10 days / 24 hoursPsilocybin: 24 hours / 24 hoursMescaline (San Pedro, Peyote): 24 hours / 24 hoursKetamine: 3 days / 3 daysAyahuasca and Analogues: 24 hours / 24 hours (NO SALT DIET = CONTRAINDICATED)GHB: 7 days / 7 daysLSD: 7 days/ 7 daysBenzodiazepines (i.e. Valium, Diazepam): 18 hours / 8 hoursTramadol: 48 hours / 24 hoursVasoconstrictors (Triptans): 3 days / 12 hoursRecovery Prescriptions (Methadone, Buprenorphine, Naltrexone): CONTRAINDICATEDAntidepressants & Anxiety Meds: Do not take morning of Kambo / 2 hoursAmphetamines (Adderall, Ritalin): 7 days / 7 daysMorphine/Oxycodone: 7 days / 7 daysCocaine/Crack Cocaine: 14 days / 14 daysCodeine: 24 hour / 24 hoursHeroine: 14 days / 14 daysMethamphetamine: 30 days / 30 daysBotox: 14 days / 14 daysFentanyl: CONTRAINDICATEDAnti-Epileptics: CONTRAINDICATEDAnti-Psychotics: CONTRAINDICATED
Pricing & Cancellation Policy:
Madeline currently offers 1:1 ceremony and group ceremonies. 1:1 ceremonies are sliding scale $200-375, and Groups are $150-275 per participant. Ceremony can range anywhere from 2-6 hours. Please pay based on your ability and what you feel this ceremony is worth to you. Madeline is available to work with payment plans and open to adjusting her rates based on ability. These sliding scales have been created with deep consideration, and the value of this medicine offering is most accurately in the center of the scale.
In order to schedule, a 50% deposit is required. This deposit is not refundable, but it is transferable, meaning it can go towards a rescheduled session, up until 48 hours (two days) before our scheduled session. If you need to cancel or reschedule within 48 hours of your ceremony, you will need to put in another deposit for your rescheduled ceremony. This helps to respect my time as well as the container.*

I understand.
Venmo for Payment:

@butterflycompost
Liability Release and Assumption of Risk

This waiver includes a comprehensive release of liability clause, stating that the participant agrees to participate voluntarily and assumes full responsibility for any outcomes. By signing this document, I absolve the practitioner, the facilitators, organizers, owners of property, and any associated individuals or entities they are affiliated with, of all responsibility for any potential injuries (physical, emotional, or psychological), loss, damage, or death resulting from participation in a Kambo (including Hapé and Sananga) Ceremony regardless of circumstances or disclosed health information. The participant acknowledges that they are voluntarily engaging in this practice at their own risk, and that they have not been coerced or unduly influenced to participate.
Signature: By signing below, you confirm that you have read, understood, and agree to the terms outlined in this document, and that you are participating voluntarily in the Kambo ceremony. This waiver is legally binding.*

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Thank you!

These are truly such a beautiful medicines and I am so looking forward to holding you in ceremony.
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✨ Kambo Ceremony ✨

To Avoid Before Kambo:

Contraindication Agreement

Medical History Disclosure

Substance Guidelines

Pricing & Cancellation Policy:

Venmo for Payment:

Liability Release and Assumption of Risk

Thank you!