Co-Creation Inquiry Form

- Step 1 of 3

Name *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Why do you feel called to bring this medicine to your community?

(What inspires you to host us, and what kind of healing or transformation are you hoping to support in your community?)

Have you personally sat in ceremony with us or with these medicines before? If so, please share your experience.

What types of medicine ceremonies are you interested in hosting?

(Check all that apply)

Do you have space in mind for the ceremony? If so, please describe the location.

(Private home, retreat center, yoga studio, etc.) And if you are unsure, that's ok, too.

Do you anticipate being able to gather at least 10 committed participants?

(Yes / No / Not sure – please explain)

Are you willing to help with some local organizing or outreach to your community?

(Such as inviting friends, sharing flyers, or helping with logistics.)

What dates or timeframes are you envisioning for the gathering?

(Give a few options or general windows of time.)

organizing you presence

Do you have overnight accommodations or housing available for us?

Anything else you’d like to share about your vision, your community, or how we might collaborate?

Do you have a website or social media presence you'd like to share?