Could you please write us a paragraph telling us a little about yourself and why you are called to participate in the Vision Quest.
Do you have any current medical conditions that could impact your ability to participate in the Vision Quest Program? Please include full details of any prescription medication or herbal remedies that you are currently taking. Please include the name and contact details of any health professionals you are currently seeing for these conditions.
If you are currently seeing a Health Professional regularly (GP, Mental Health, Naturopath or Specialist in any other field) please detail below what this treatment is for and also provide their current contact details.
Do you have any SERIOUS food allergies that cause medical complications? If yes,
please list them, and rate the severity on a scale of 1-10.
If yes, please explain.
If yes, please explain:
If YES, please explain
If YES, at what age?
We would love to know more about the unique wisdom you will carry into your Vision Quest. Have you undertaken any other training/courses that you would like to tell us about that might give us a greater understanding of this?
Thank you for taking the time to fill out this form.
All information provided is kept COMPLETELY CONFIDENTIAL and ensures that when your application is approved your Vision Quest will be a safe and rewarding experience.