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Contraindication and substance guideline understanding and agreement

Things that should be avoided before Kambo. Please read carefully. Mixing Kambo with any of the following could be extremely dangerous.

  • Immune suppressants for auto immune disorders. 
  • Slimming or sleeping supplements (including melatonin)
  • Alcohol or drugs 24 hours before and after
  • Do not fast 7 days before or after Kambo
  • Colonics, enemas, liver flushes or any water based detox should be avoided within 3 days either side of taking Kambo

By checking the "I Agree" box you are agreeing that you have read the above regarding what should be avoided before Kambo and that you understand the dangers involved should you choose to neglect the above.

I Agree

 Kambo is very safe when given by a properly trained practitioner however there are some conditions for which Kambo is contraindicated, You should absolutely not participate in a Kambo treatment if any of the following apply.  

  • Have serious heart problems.
  • Have Elhers Danlos
  • Are on medication for low blood pressure.
  • Have had a stroke. 
  • Have had a brain hemorrhage.
  • Have an aneurism or blood clots.
  • Lack the mental capacity to make the decision to take Kambo. 
  • Have serious mental health problems excluding depression, PTSD and anxiety. 
  • Are undergoing chemotherapy, radiotherapy or for 6 weeks afterwards. 
  • Take immune-suppressants for organ transplant.
  • Have Addison’s Disease
  • Have current and severe Epilepsy
  • Are recovering from a major surgical procedure
  • Are under 18 years old
  • Have undergone a Bufo ceremony in the past 6 weeks
  • Are pregnant or maybe so or are breast-feeding a child under 6 months old
  • Taking Diuretics
  • Person has consumed other strong medicines (eg. San Pedro, Ayahauaca, Mushrooms) within 24 hours of wanting to receive Kambo
  • Person has reached their 70th birthday
  • The person has consumed large amounts of water prior to arriving for Kambo

By checking the "I Agree" box you are agreeing that you have read the above regarding contraindications of Kambo and that you understand the dangers involved should you choose to neglect the above.  

I Agree

Substance Guideline List

Please review the below list of substances that should be abstained from before and after taking Kambo. By checking the "I Agree" box to each substance you are confirming that you understand the time period to abstain from that particular substance both pre and post Kambo and that you understand the dangers involved should you choose to neglect the information provided to you regarding the substance guideline.  

SUBSTANCE                MINIMUM ABSTINENCE PERIOD PRIOR TO KAMBO /  POST KAMBO 

Alcohol High Doses       48 HOURS  / 7 DAYS

I Agree

Alcohol Low Doses        12 HOURS / 24 HOURS

I Agree

Amphetamines  Including Adderall and Ritalin     7 DAYS / 7 DAYS

I Agree

Anti-Depressants and Anxiety Medication including Duloxetine/Cymbalta  Do not take morning of / 8 hours  

I Agree

Anti-Epileptics    CONTRAINDICATED  

I Agree

Anti-Psychotics  CONTRAINDICATED  

I Agree

Ayahuasca & Analogues e.g.   24 hours / 24 hours  

I Agree

Benzodiazepines e.g. Valium, Diazepam  18 hours / 8 hours

I Agree

Beta Blockers  Do not take morning of treatment / 8 Hours

I Agree

 Blood Thinners   Do not take morning of treatment / 8 Hours   

I Agree

Botox   7 days / 7 days

I Agree

Bufo, 5-meo dmt    6 weeks / None  

I Agree

Cannabis    12hrs / 24hrs  

I Agree

Cocaine    3 days / 5 days  

I Agree

Coca Leaf    12hrs / 24hrs   

I Agree

Codeine    24 Hours / 24 Hours  

I Agree

Crack Cocaine    7 days / 7 days  

I Agree

Ecstasy (MDMA) Molly or any other MD**    7 Days / 7 Days  

I Agree

Fentanyl    CONTRAINDICATED  

I Agree

GHB    7 Days / 7 Days  

I Agree

Heroin (recreational)    14 Days / 14 Days  

I Agree

Heroin Substitutes  – Methadone, Buprenorphine, Naltrexone    CONTRAINDICATED   

I Agree

High Blood Pressure Medication    Do not take morning of treatment / 8 Hours  

I Agree

Iboga    90 days / 24 Hours  

I Agree

Ibogaine    10 days / 24 Hours  

I Agree

Ketamine    3 Days / 3 Days  

I Agree

Krokodil (Desomorphine)    CONTRAINDICATED   

I Agree

LSD    48 Hours / 72 Hours   

I Agree

Meth Amphetamine    30 Days / 30 Days  

I Agree

Morphine/ Oxycodone    5 Days / 5 Days

I Agree

N, N-DMT    8 Hours / 8 Hours  

I Agree

Nitrous Oxide    12 Hours / 12 Hours  

I Agree

Peyote San Pedro (Mescaline)    24 hours / 24 hours   

I Agree

Pink (U-47700)    CONTRAINDICATED   

I Agree

Psilocybin    24 hours / 24 hours  

I Agree

Research ChemicalsSPICE, Bath Salts, Mephedrone, Synthetic cannabinoids + more    For limited recreational usage, 30 days before treatment.  Habitual use is contraindicated / 30 Days  

I Agree

Tramadol    48 Hours / 24 Hours  

I Agree

Vasoconstrictors (Triptans)    3 Days / 12 Hours  

I Agree

2CB    48 Hours / 3 Days  

I Agree

 

Tribal Detox

“Kambo Treatment”
Release of Liability and Assumption of Risk Agreement 

Disclaimer: 

Kambo is the sweat from the Bicolor Phyllomedusa frog. Traditionally, Kambo is and has been used by indigenous peoples of the upper Amazon to lift Panema (dark or negative energy) and for Hunting Magic. Your organizer and practitioner are not licensed in the medical field and do not diagnose or prescribe any medications for any conditions nor do they diagnose, treat or cure any medical conditions. Kambo treatment should not be used as a substitute for medical care and advice from your physician. Please contact a qualified, licensed physician for any illness or disease. 

In consideration for being allowed to participate in the Kambo treatment I agree to the following: 

1.         I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY (reimburse for any loss including any reasonable legal fees they may incur), AND HOLD HARMLESS THE ORGANIZER AND KAMBO PRACTITIONER, their officers, officials, agents and/or

employees, other participants, and, if applicable, owners and leasers of premises used for the Kambo treatment ceremony. (“RELEASED PARTIES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE, to the full extent permitted by law. I KNOWINGLY AND FREELY ASSUME ALL RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGNCE OF THE RELEASED PARTIES or others, and assume full responsibility for my participation; and 

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. 

 

 

 

 

 

                        

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

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Third Participant's Date of Birth*
Fourth Participant's Name

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Fourth Participant's Date of Birth*
Fifth Participant's Name

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Fifth Participant's Date of Birth*
Sixth Participant's Name

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Sixth Participant's Date of Birth*
Seventh Participant's Name

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Seventh Participant's Date of Birth*
Eighth Participant's Name

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Eighth Participant's Date of Birth*
Ninth Participant's Name

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Ninth Participant's Date of Birth*
Tenth Participant's Name

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Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information on dates / locations and costs of Tribal Detox Kambo Events
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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