Intake Form

We facilitate a limited number of private ceremonies each month to ensure absolute presence. Please select the pathway that aligns with your current seeking.

FILL OUT THE INTAKE FORM

Please provide your details with transparency, allowing us to build a foundation of safety and resonance before our Sacrament.

Name
Address
Booking Date
Type of booking
Preparation Window
Integration Window
Best Time For a Discovery Call?
Are you currently experiencing depression, emotional instability or thoughts of self harm?
Are you currently in therapy or receiving mental health support?
Are you currently pregnant?
Do you regular use alcohol, cannabis, or other substances?
How would you like to be contacted?
Exchange Acknowledgment
I understand that there is no fixed fee for this sacred work. I have reviewed the 'Sacred Donation' philosophy and am prepared to offer a contribution that reflects the value of the container and the facilitator’s dedication.
Terms of Service (copy)
Terms Of Service

1. Nature of the Offering
By submitting this intake form, I acknowledge that the offerings provided by Axis of Being are strictly spiritual, educational, and ceremonial in nature. I understand that the facilitator is acting in a spiritual capacity and is not a licensed medical doctor, psychiatrist, or clinical therapist. No part of the ceremony, consultation, or integration is intended to diagnose, treat, or cure any physical or mental health condition.

2. Full Disclosure and Medical Safety
I certify that all information provided in this form is true, complete, and accurate to the best of my knowledge. I understand that the sacrament involved has specific physical and psychological contraindications. I agree to disclose all current medications (specifically SSRIs, MAOIs, and heart medications) and health conditions. I acknowledge that withholding health information poses a significant risk to my physical safety, for which I assume full responsibility.

3. Assumption of Risk
I am choosing to participate in this experience of my own search and volition. I am aware that ceremonial work can involve intense emotional, physical, and psychological states. I voluntarily assume all risks associated with the experience, including the potential for profound shifts in my perception of reality and my emotional state.

4. Sacred Reciprocity (Donation Basis)
I understand that the ceremonies are gifted and that any financial exchange is a voluntary donation intended to support the facilitator’s time, travel, and the ethical sourcing of ceremonial materials. I acknowledge that this donation is not a payment for a "result" or "service," but a gesture of reciprocity within a spiritual tradition.

5. Privacy and Confidentiality
Axis Of Being agrees to keep all personal and medical information shared in this form strictly confidential. Conversely, I agree to respect the privacy of the facilitator and the sanctity of the ceremonial space. Recording of any kind (audio or video) during the ceremony or consultations is strictly prohibited without express written consent.

6. Right of Refusal
I understand that submission of this form does not guarantee an invitation to a ceremony. The facilitator reserves the right to decline any applicant at their sole discretion if they feel the container is not a safe or resonant fit for the individual at this time.

7. Personal Sovereignty
I take full responsibility for my own integration and aftercare. While the facilitator provides support, I acknowledge that the ultimate responsibility for my mental and physical well-being remains with me. I agree to consult with a medical professional if I have any concerns regarding my health prior to or following the experience.

Frequently asked questions

What is Axis Of Being Sacrament?

Communion with the divine may occur through many pathways, including silence, breath, nature, sound, movement, and sacred ceremony. We honor the use of natural sacraments of divine origin, sacred tools gifted by the Earth and Source of All Creation. These sacraments are not for recreational or casual use. Their purpose is spiritual awakening, divine communion, and the souls remembrance of truth.

When approached with reverence, preparation, guided support, and ethical stewardship, natural sacraments may open pathways of spiritual communion, expand awareness, and deepen the remembrance of our unity with all life.

What is Bufo / 5-MeO-DMT?

Bufo (5-MeO-DMT) is a naturally occurring psychoactive compound known for producing profound altered states of consciousness. Individuals may experience emotional release, shifts in perception, or experiences described as spiritually or existentially meaningful.

Experiences vary widely. No specific outcomes can be guaranteed.

What is the purpose of this work?

This work supports individuals navigating personal transformation, spiritual exploration, or meaningful life transitions. The approach emphasizes preparation, ceremonial integrity, and integration to support sustainable and responsible transformation.

What is your role as a facilitator?

My role is to uphold a safe, respectful, and ethically grounded ceremonial container. This includes supporting preparation, providing steady presence during experiences, and offering structured integration support afterward.

I do not impose interpretations or direct the content of an individual’s experience.

How is participant safety assessed?

All participants complete a screening and readiness process which may include:

• Medical and mental health history review

• Medication and contraindication review

• Emotional and psychological readiness assessment

• Support system evaluation

• Intention and expectation discussion

Participation may be postponed or declined if safety concerns are identified.

What does preparation involve?

Preparation supports physical, emotional, and psychological readiness. It may include educational sessions, intention development, grounding practices, and structured preparation meetings prior to participation.

Preparation is considered essential to ethical ceremonial work.

Why is integration emphasized?

Integration supports individuals in processing and applying insights following an experience. Without integration support, transformational experiences can be destabilizing or difficult to meaningfully incorporate into daily life.

Integration may include coaching, somatic practices, reflection, and continued support planning.

Is this therapy or medical treatment?

No. This work is non-clinical and does not replace medical or mental health care. Participants are encouraged to maintain relationships with licensed healthcare providers when appropriate.

Are there contraindications?

Yes. Certain medical conditions, medications, or mental health histories may increase risk. Safety and ethical responsibility guide all participation decisions.

Are medication changes required?

Medication decisions must be made with licensed prescribing providers. I do not offer medical or medication guidance.

What expectations should participants have?

Participants are encouraged to approach this work with openness, personal responsibility, and willingness to engage in preparation and integration. Experiences vary widely and cannot be predicted or guaranteed.

Are you affiliated with a spiritual or religious organization?

Yes. I currently facilitate within a spiritual and educational framework and maintain affiliation with Sunflower Congregation. My work focuses on preparation, support, and integration within ethical and spiritual contexts.

How do individuals begin working with you?

Participation typically begins with an inquiry and screening conversation to assess readiness, alignment, and safety.

Realign, Remember, Return