Medicine Inquiry

Sacred Medicine

This sacred journey requires readiness to engage in deep inner work and to meet the medicine with presence and intention. Preparation and integration are not only essential—they are part of the medicine itself. Equally important is the relationship between the participant and the facilitator; this connection lays the foundation for a safe and aligned container.

The way that I work with this medicine is always combined with a very intentional coaching container to help you close the gap between what you know- and how you actually live. The intention is to learn to finally create more peace, sovereignty, and the life you enjoy living.

Each person’s path is unique, and alignment will be assessed individually.
Please take time to reflect and share below.

Name

First NameLast Name

E-mail

RE-enter email

Phone Number

Format: (000) 000-0000.

Re-enter Phone Number

Format: (000) 000-0000.

Are you on Signal?

If so please add your country code

Are you using street drugs or pharmaceuticals? If yes please describe

Please describe your perspective of your mental health

Have you ever had a psychotic break?

Please tell me a bit about yourself and what you are looking to work on.

What is your previous personal growth and psychedelic experience?

What’s the biggest challenge you’re facing right now? (Or: what’s not working the way you thought it would by now?)

What are your main intentions for this work? (Choose what feels most true.)

What healing or plant medicine work have you done previously?

What’s your main reason for booking this call? (What do you want to get clear on, shift, or finally release?)

Are you currently in good physical health with no major medical conditions? (Yes/No + brief details if relevant)

Have you had any history of heart issues, psychiatric conditions, medications, or substance use that might be relevant for Iboga? (Yes/No + details)

Do you have any active addictive patterns (substances, behaviors, etc.) that you’re hoping this work can help address?

How ready are you to commit to the full preparation, the Iboga experience, and the integration work afterward? (1-10)

Are you open to a structured coaching container alongside the Iboga work to support real, lasting transformation? (Yes/No + notes)

Are you ready to make a meaningful investment in your healing and transformation at this time?

What investment range are you prepared to make for the full Iboga experience (preparation, medicine work, integration, and coaching support)?

How did you find me?

Other

**Commitment** Type "YES" below if you are 100% committed to showing up fully for this call. "I Promise I Take This Seriously & Will Be Fully Present on This Call from a Quiet Space on My Laptop."

Once you submit this form you will be taken to a page to book a discovery call if you feel ready.