The assessment below is a criticial tool for both the client and the practitioner and an extremely important part of the intake process. It helps the client get clear on their intention and expectation in working with Kambo, and it helps the practitioner determine if it safe for the client to receive the medicine, how many gates/points they will need, and the best course of treatment for their specific situation.

Following the submission of this form, please continue to step 2 to book your consulation.

*Your information is held sacred and is 100% confidential. Please be honest with your responses, open with your concerns and transparent with your intentions. Your safety is my ultimate priority.*