| examples: high blood pressure, heart conditions, diabetes, epilepsy, asthma, etc. |
| |
| It is very important that we know about any heart issues so please inform us if there are. |
| |
| If you want to provide more detailed information |
| Programs involve some hiking, frequent walking, and spending time in hot, humid conditions |
| types of activities you do, frequency, and any limitations |
| heat exhaustion, heat stroke, etc. |
| |
| depression, anxiety, bipolar disorder, schizophrenia, psychotic disorders, etc. |
| diagnosis, treatment history, current status, and any hospitalizations |
| |
| If you want to provide more detailed information |
| |
| when, frequency, and any professional support received |
| ability to handle stress, adapt to challenges, or process intense emotions |
| |
| Write "healthy" if you have no issues |
| Ayahuasca can interact negatively with certain medications |
| medications/supplements, dosages, and reasons for use |
| food, environmental, insect bites, etc. |
| |