Use this page as your step-by-step guide to our Health & Safety Questionnaire for Transcendent Psychology retreats. It explains why we ask what we ask, how we protect your data, and how to complete the form smoothly.
What this questionnaire is
The Health & Safety Questionnaire is a mandatory part of your registration. We use it to identify risks and to keep you and the group safe. Your participation can only be confirmed once the form is completed in full and signed.
Sessions are designed for personal growth. They are not a substitute for psychotherapy, medical, or psychiatric care.
What we ask
You’ll provide contact details and emergency contact information, note current and past health conditions, list medications and supplements, and answer focused questions about mental and physical health. Please answer completely and honestly and include any relevant issues not explicitly listed on the form.
There is also a signed declaration confirming you have read the information, answered honestly, and understand that withholding information can create risks for you and others.
How we use your answers
Your answers guide screening and preparation so facilitators can anticipate needs, reduce risks, and plan appropriate care. Thorough pre-selection using the medical form and a brief pre-interview significantly reduces the chance of emergencies during a session.
Privacy & data protection
Your information is stored securely and kept confidential under current regulations. In the EU, the form includes a GDPR clause describing purposes such as organizing the session and managing participant medical files, plus how to exercise your data rights.
Medications & interactions
Plant medicine can amplify or adversely interact with certain substances, which is why we need a complete list of everything you take, including dose and timing. Some combinations—such as monoamine oxidase inhibitors, many antidepressants, other serotonergic drugs, and substances like MDMA—are risky. Do not discontinue prescribed medication without medical advice; if a change is appropriate, your doctor will guide the taper and timing.
Health conditions & exclusions
For safety, participation is not recommended in cases of severe or unstable medical or psychiatric conditions (for example certain cardiovascular diseases, glaucoma, recent fractures or surgery, pregnancy or nursing, acute infections, epilepsy or seizures, prior stroke, severe liver/kidney/pancreatic disease, or serious psychiatric disorders like psychosis, bipolar disorder, or borderline personality disorder). Screening helps determine when additional evaluation or support is needed.
Emergency contact
You will name a reachable emergency contact and authorize us to inform them if an emergency occurs. Facilitators rehearse how to communicate essential information to this person if needed.
When to complete it
Complete and sign the questionnaire as soon as you consider attending. Registration cannot be confirmed until we have your signed form, and additional clarification may be requested during the screening interview.
FAQs
Why is honesty so important?
Accurate answers help us prevent avoidable risks. Incomplete or inaccurate information can endanger you or others. The Honor Pledge explicitly asks participants to answer truthfully and acknowledges the risk of withholding information.
Do I need to list supplements and recent medications?
Yes. Include prescriptions, over-the-counter products, and supplements taken in the past months, with dose, frequency, and duration.
Will my data be shared with anyone?
Only with designated team members as needed to run the session safely, according to the data protection clause in the form.
What happens if something urgent comes up during a retreat?
We follow a written emergency protocol, keep essential medical info at hand, and can contact your emergency person. Having first-aid capacity on the team and clear plans are standard.
How to complete the form well
Set aside quiet time. Gather your medication list, recent medical history, and your emergency contact’s name and number. If you are unsure about a condition or prescription interaction, consult your clinician first and note their guidance on the form. Remember: do not stop prescribed medication without medical advice.
Final step
When you’re ready, complete the Health & Safety Questionnaire and sign the declaration. If you have questions after reading this page, contact us—our team can clarify what to include and how your information is protected. Once we receive your signed form, we’ll finalize your screening and confirm next steps.
Sources adapted for safety and screening best-practices: Health Questionnaire (AyaSafe 2), Emergency Protocols (AyaSafe 5), Honor Pledge & Consent (AyaSafe 4), and Guide for New Participants (AyaSafe 1).