• Home
  • Services
    • Additional Services: Kambo Ceremonies
    • Additional Services: Tobacco Cleansing
    • 1 Day Trip: Casco Antiguo Cultural Exploration
    • 1 Day Trip: Panama Canal
    • 1 Day Trip: Beach Getaway
    • 1 Day Trip: Mountain Hike or Outdoor Yoga
  • Your 7 Day Program
  • About
  • Contact
Menu
  • Home
  • Services
    • Additional Services: Kambo Ceremonies
    • Additional Services: Tobacco Cleansing
    • 1 Day Trip: Casco Antiguo Cultural Exploration
    • 1 Day Trip: Panama Canal
    • 1 Day Trip: Beach Getaway
    • 1 Day Trip: Mountain Hike or Outdoor Yoga
  • Your 7 Day Program
  • About
  • Contact
Sign Up
Ayahuasca Ceremony Intake Form
Please fill out the following information before participating in the ayahuasca ceremony. This information will help us ensure your safety and well-being throughout the ceremony. All information provided will be kept confidential.

Personal Information:

*
*
*
 / 
 / 
*
*
*
*
*
*
*
*
*
*
*
*
*

DECLARATION:
I, [Your Name], hereby confirm that all the information provided above is true and accurate to the best of my knowledge. I understand that participating in an ayahuasca ceremony involves potential risks and that the facilitators cannot be held responsible for any unforeseen circumstances or outcomes.

*
*

THE DIET AND HOW TO PREPARE FOR THE CEREMONY
Ask any questions about a specific personal diet depending on the individual's activity. In the case of women, if they are in the menstrual cycle or pregnant, they should consult the officiant of the Ceremony to ingest Ayahuasca.

IN THE WEEK BEFORE THE CEREMONY:

· The consumption of food should be easily digestible, avoiding foods that are too sweet, spicy or highly seasoned.
· Do not consume ANY pork and derivatives such as cold cuts and sausages.
Do not consume dairy
· The day of the ceremony Do not consume foods rich in vitamin C.
· NO alcohol, drugs, cannabis or other substances.
· If you are taking psychiatric or other medications, you must inform us so that we can recommend the best for you to guarantee your experience without affecting your health.
· Avoid red meat and animals larger than people. You can eat white meat; turkey, chicken, smaller animals, fish and cooked free of fat as natural as possible.
· The sexual practice must also be suspended, at least, three days before.
Eliminate coffee intake at least three days before

PROTOCOL
•The event is aimed at a limited group of participants.
• Registration for this day is personal and non-transferable.
• We reserve the right of admission of the participants.
•In the Ceremonies with Ayahuasca Relief, only the people who participate in it are in the room.
•During the Ceremonies with Ayahuasca Relief, the participants will not be able to leave the space until it is closed.
•My participation in the ceremony is completely voluntary, at no time have I been induced, forced or manipulated to be in it.
•I have been informed and accept that it is contraindicated to take Yagé/Ayahuasca (also called “medicine”) if you have open wounds from recent operations.
•I have been informed, I accept and I assume my responsibility in that taking Yagé/Ayahuasca can produce different physical, emotional, psychic and/or energetic reactions.
•I have been informed and accept that taking Yagé/Ayahuasca can cause dizziness and I assume responsibility for any type of fall during and after the ceremony.
•I accept that I must previously inform those responsible for the ceremony about any medical treatment in which I find myself, be it physical or psychiatric.
•I accept that no observers or visitors are allowed at the ceremony and therefore if I am in the physical location of the ceremony I agree to participate taking the medicine at least once.
•I agree to abide by the recommendations of the organizers during the therapy.
•I agree to keep cell phones turned off and without batteries to avoid noise during the night, as well as to refrain from using them in any way during the ceremony.
•I have been informed and I accept that it is not allowed to bring or carry alcoholic beverages, cigarettes, drugs, or any other substance, other than the medicine supplied by the work team.
•I promise not to receive any other illegal substance or other than the indigenous ancestral medicine provided by the organizers.
•I promise to prepare myself a week before with diet and everything else required here in this statement.
•I have been informed and accept that the organization reserves the right to denounce any use of illegal substances and/or weapons that may occur in its facilities, for the safety of its participants, users and organizers.
•I promise to contribute to the proper functioning of the bathrooms, and to the order and cleanliness of the site, following the instructions given during the ceremony for this, using the bins and bags provided by the organizers.
•I promise not to enter the rooms and areas restricted to members of the work team.
• In the event of material damage, the person and/or persons responsible will pay the full amount of the damage.
•Leave that place as you found it and take care of what is Sacred.
•Those people who have not performed any ceremony must request a free telephone or personal interview to study their profile, personal motivation, admission and job orientation.

*

Diet

DIET

The diet before your first Ayahuasca ceremony is extremely important to follow as well as the diet during the retreat and the after diet as well. If not followed correctly can be detrimental to your mental, emotional, spiritual, and physical wellbeing.

Ayahuasca Diet

Before

  1. No sex or masturbation (3 days)
  2. No alcohol (3 days)
  3. No pork (2 weeks)
  4. No marijuana (1 month)
  5. Any medications that react with MAOI INHIBITORS for (1 month), (6 weeks) for Prozac.
  6. No illicit drugs minimum (2 weeks)

This is so extremely important for your safety and for you to be able to integrate deeply.

Ayahuasca Diet

During

  1. No sugar
  2. No sweet fruit
  3. No citrus
  4. No salt
  5. No chillis
  6. No pork
  7. No drugs
  8. No alcohol
  9. No sex or masturbation
  10. No coffee

During the retreat, your food will be taken care of for you. Please do not bring any food from the outside into the retreat center.

Ayahuasca Diet 7-Days

After

  1. No sex or masturbation for 8 days
  2. No salt
  3. No sugar
  4. No fruit
  5. No citrus
  6. No Vinegar
  7. No pork
  8. No dairy (Cheese, milk, butter, etc.)
  9. No chilis or hot peppers
  10. No drugs or alcohol
  11. No egg yellow
  12. No caffeine

To follow this after diet after working with the Ayahuasca and/or San Pedro is so vitally important for your healing and growth process.

7- Day ayahuasca after diet grocery planner

What You Can Eat

All vegetables

Rice, oatmeal & all grains

Beans & lentils

Chicken, fish & egg whites

All nuts

A little natural vegetable oil

Traditionally there are special diets that accompany many spiritual practices throughout the world. Fasting, avoiding and consuming specific foods and many other lifestyle alterations to optimize and create a state in the one that is strictly adhering to such regimes to create within oneself the openness and ability for information, growth, and connection with the proper intent to reach greater levels of awareness and understanding. The traditional diets for the Shamans that work with Ayahuasca spend months in the jungle having minimal or no other human contact and absolutely no sexual contact, only consuming boiled or roasted fish, plantains, rice, and yucca containing no salt, sugar or oil.

Over time of such strict diets and isolation while working in the ceremonies with the Ayahuasca a whole new world opens up to them and they begin to be taught many things about life, the spirit world and the medicinal plants that can be used to help cure and treat many conditions and diseases. When they return from their long diet they then begin to use their newfound knowledge to help heal on a physical and spiritual energetic level people who need such healing and help.

Wanting the most out of the retreat I recommend cleaning up one’s diet and reducing stimulus of the senses about a month before the retreat so the mind can be in a more receptive, aware and more conscious state to reap the greatest benefit and vision. Ideally, a very strict diet even though not necessary I recommend would benefit you the most. The stricter the diet the more lasting and profound the changes will become, so it is very important to take seriously this work for what it is and prepare mentally and physically for your visit with us.

Here is listed the necessary diet before you travel to Peru and work in the ceremonies with Ayahuasca, and if you choose to further immerse yourself for a richer experience, I recommend a stricter diet over a longer duration before you come.

Absolutely NO PORK two weeks prior to your first ceremony

Street Drugs & Alcohol

Abstinence from all street drugs & alcohol at least 2 weeks prior to your first ceremony. I recommend 4 weeks for a little more time, for your brain, to balance more, before you come, yet 4 weeks is not mandatory, 2 weeks will suffice.


Sexual Contact & Stimulation

Avoid sexual activity with a partner and personal for a minimum of 3 days prior to your first ceremony. I recommend a week or more if possible and absolutely no sexual contact during the time with the sacred medicines.


Medications

Any medicines or supplements that will react negatively with MAOI inhibitors need to be discontinued a minimum of two weeks before having your first ceremony. Because the Ayahuasca vine contains the plant chemical harmaline, which is an MAOI inhibitor. A list is provided below but I recommend you speak with your doctor and do your diligent research to make sure any medication you need, will not be a potential for harm to yourself while working with the sacred medicine Ayahuasca.

Restricted Medications

I would still double-check with your doctor if your medication is not on the list. If the drug you are taking is not on this list please check with your doctor if it has a negative reaction with an MAOI inhibitor. If you are taking any of these drugs you must stop taking them at least two weeks before your first ceremony with Ayahuasca.

Citalopram (Celexa,Cipramil)

Escitalopram (Lexapro, Cipralex, Seroplex, Lexamil)

Fluoxetine (Prozac,Sarafem, Symbyax) (requires 6 week abstinence)

Fluvoxamine (Luvox)

Paroxetine (Paxil, Aropax)

Sertraline (Zoloft)

Desvenlafaxine (Pristiq)

Duloxetine (Cymbalta)

Milnacipran (Ixel)

Venlafaxine (Efflexor)

Sibutramine (Sibutramina, Meridia, Obestat, Rectiva, Raductil,)

Clomipramime (Anafranil)

Imipramine (Tofranil)

Protriptyline (Vivactil)

Vilazodone (Viibryd)

Pethidine (meperidine) (Demerol) could be fatal reacton.

Methadone

Tremadol (Ultram)

Dextropropoxyphene (Darvon)

Pentazocine (Talwin, Fortral)

Dextromethorophan

Chlorpheniramine (Hystop, Chlor-Trimeton, Piriton, HISTA-12)

Bromopheniramine (Bromafed, Dimetapp, Bromfenex, Dimetane, BPN, Lodrane)

Linzolid (Zylox)

Nitrofuran (Furoxone)

Procarbizide (Matulane)

Nudexa (dextromethorphan and quinidine sulfate)

Tryptophan

MDMA (ecstacy)

**2 to 4 weeks are necessary to be free from such medications to avoid any serious health consequences**

Restricted Herbs

These Herbs Should not be consumed for at least two weeks before your first ceremony.


• St. Johns Wort

• Velvet Bean

• Kava

• Ephedra

• Ginseng

• Yohimbe

• Sinicuichi

* All other herbs, if they are not necessary, should be avoided during the time period of the ceremonies.

MAOI Interaction Food List

There are many foods that are cross-reactive with the MAOI inhibitor harmaline that is contained in the Ayahuasca vine. Below will take you to a food list that contains foods to be avoided. This should not be a problem since we will be providing all the meals during your stay while at the lodge. All the foods on this list are cross-reactive with Ayahuasca and should be avoided at least 24 hours before your first ceremony and not consumed during your stay at the retreat.

Meat that is not fresh do not consume

Do not consume any smoked, pickled or un-fresh fish

Aged Cheeses

Sausage, Pepperoni, salami, corned beef

Protein extracts

Powdered or liquid protein supplements

Yeast vitamin supplements, Brewers yeast or yeast extracts

Soy sauce, fermented tofu, fermented soybean paste, fermented bean curd

Canned soups, soups made with bullion or protein extracts

Shrimp Paste

Sauerkraut

Fruits that are bruised or even slightly overripe, raisins and other dried fruit, especially overripe bananas and apples

Miso Soup

Avacadoes, if ripe or overripe (slightly underripe avocados ore ok)

Wine, beer and ales

Dairy if it is close to the expiration date

Aspartame

Fava beans

Peanuts

Raspberries

Spinach

Chocolate

Any beverage containing caffeine (large amounts) a little tea in moderation is ok.

The reason to avoid these foods during the retreat is because over ripe fruits and old meats contain tyramines that can have a dangerous reaction with the MAOI Harmaline that is present in the Ayahuasca vine.

*
Facebook Youtube Instagram