Skip to main content

Sattvaya Contact


Reservation form


Signing up and booking Ayahuasca & Teacher plant medicine retreat

Do you want to have an unforgettable experience? Then book your place right away by filling in the form below. Upon receipt, you will automatically receive a message from us confirming your registration. We will then contact you as soon as possible to confirm your participation, and if necessary we will go through the information with you personally.

Are you interested in participating but still have questions or doubts. Then sign up via our registration form. 


Explanation of the questionnaire

For the safety of (all) our participants, we feel it is important to gather some background information, regarding everyone's current situation We do this to determine for all participants whether we feel it is safe and responsible to experience this deep experience, and to be able to support everyone in the best possible way (during the inner-journey).

Support of your process

This form is specifically designed to help you explore whether a journey with Ayahuasca Plant Medicine, accompanied by us, is the right decision for you at this point in your life. If you choose to attend a retreat with us, the information you provide in this form will also help us to best support your individual process.

Risks of using entheogens like Ayahuasca

Working with Plant medicines like Ayahuasca is not without risks. In some mental or physical conditions, it is not wise or even dangerous to drink the medicinal drink. Besides, the MAO-inhibiting substances in Ayahuasca can give contraindications for certain medicines (SSRIs), herbal preparations and drugs. Therefore, we also ask you to fill in this health statement at your official registration.

Sattvaya does not offer regular therapeutic or clinical support and can therefore only offer a safe space for participants in good mental and physical health.

Contra-indications

The most common reasons why someone may not be able to participate in our retreats are:

  • Severe cardiovascular problems (e.g. a recent stroke or heart attack).
  • Neurological problems (e.g. epilepsy or brain trauma).
  • Use of antidepressants (e.g. SSRI/TCA).
  • Mood stabilising drugs (e.g. lithium) or antipsychotic drugs (e.g. Abilify) medications.
  • Addiction to recreational drugs (e.g. cocaine, speed but also alcohol).
  • Severe mental health problems (e.g. psychosis, schizofrenia, bipolar disorder insome cases possible)

Such conditions and medications carry additional risks: they do not combine well with Ayahuasca-related medicinal drinks, and can create potentially dangerous situations that we cannot guarantee to manage safely in a group retreat setting. It is therefore in your and everyone's best interest to answer the following questions truthfully and accurately.

Check this page for all information on contraindications!

Personal details

We keep your data carefully and only for our own use and absolutely not shared with other parties!

Please type your full name.
Please type your full name.
Please type your full name.
Invalid email address.
Invalid Input
Please type your full name.
/ / Invalid Input
Invalid Input
Invalid Input
Invalid Input

Retreat Reservation






Invalid Input

Personal Motivation and Situation

Invalid Input
Invalid Input
Invalid Input
Invalid Input

Mental Health

Invalid Input






Invalid Input
Invalid Input



Invalid Input
Invalid Input




Invalid Input
Invalid Input




Invalid Input
Invalid Input
Invalid Input

Physical Health

Invalid Input






Invalid Input



Invalid Input
Invalid Input

Additional questions

Invalid Input
Invalid Input
Invalid Input
Invalid Input

I have completed all the questions truthfully and accept the terms and conditions of Sattvaya

Invalid Input
Invalid Input

Aanmelden Retreat