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Kambo Client Care Form

Kristine Ovsepian

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Kambo Client Care Form







Emergency Contact:



Do you suffer from any of the following?

Serious heart problems

Medicated low blood pressure

Abnormally high or low blood pressure

Stroke, brain hemorrhage, aneurysm, blood clots

Lack the mental capacity to make the decision to take Kambo

Serious mental health problems

Undergoing or have been undergoing chemotherapy or radiotherapy

Taking immunosuppressants for an organ transplant

Addison’s Disease

Current and severe epilepsy

Recovering from a major surgical procedure

Taking immunosuppressants for autoimmune disorder

Serious eating disorder e.g. Bulimia or Anorexia

Active drug addiction

Take regular high doses of slimming, serotonin and/or sleeping supplements

Fasted for more than a few days before Kambo

Liver or Kidney problems

Asthma

Diabetes

Regularly consume diuretic medications or sports drinks

Have you participated in a Bufo ceremony in the last 8 weeks
 

Females only:

Are you pregnant or are you breastfeeding a child under 6 months old

Undergoing fertility treatment

Other considerations:

  • We strongly advise against enemas, colonics, liver flushes, or any water based detoxes within 5-7 days before and after taking Kambo
  • We also strongly advise that you DO NOT consume more than 2.5 liters of water during a single treatment (including 2 hours before and after the Kambo session)
  • People with asthma need to bring their inhaler with them to the Kambo session
  • Diabetics need to bring insulin, testing strips, and extra food
  • Menstruation flow may increase 24-36 hours following the Kambo treatment
  • It is completely safe to continue to take any other medication, however please discuss this beforehand

Disclaimer:

I understand that Kambo International practitioners are not medical doctors, nor any other form of medical practitioner.

I understand that Kambo International practitioners do not diagnose disease, offer health advice, treat physical or mental health issues, or prescribe medicine or pharmaceuticals.

I understand that any complementary therapy treatment which I receive is not a substitute for a medical or psychological diagnosis or treatment by a qualified medical practitioner.

I understand that it is recommended that I see such a practitioner for any physical or psychological problem I have now or in the future.

I confirm that I have read and understand the list of contraindications provided and agree that I do not have any conditions that would contraindicate me from taking Kambo.

I further confirm that all the details provided are true and accurate.

I hereby release Kristine Ovsepian and Journeys to Heal from any and all liability resulting from the use of equipment, materials, preparations, remedies, or treatments and assume full responsibility for all risks regarding this treatment.

I confirm that I am of lawful age and fully understand the contents of this document.

Please Review & Sign This Document

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Kambo Client Care Form

Kristine Ovsepian

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