Our comprehensive screening questionnaire has been developed in partnership with the International Centre for Ethnobotanical Education, Research and Service (ICEERS). Please take your time to answer it as honestly and with as much detail as possible. This information will remain strictly confidential and will only be used to assess your suitability for a place on retreat with AYA Healing Retreats and keep you safe

Please remember that the purpose of this screening questionnaire is to determine whether plant medicine healing is suitable for you…not whether you are suitable for plant medicine healing. Plant medicines are tools, like any other healing modality and like other tools for healing experiencing them entails certain risks. We need to make sure that our plant medicines will not compromise your wellbeing or harm you in any way before we allow you to begin your healing journey with us. In short, we care about your safety and we need to do what we can to ensure that during your time with us you are not at risk of harm. Plant medicines can be dangerous if the plants are not the right fit for the individual. Your answers to this questionnaire will help us to determine whether the plants we intend to use are going to help, rather than harm you