Plant Medicine Retreat Application

Thank you for your interest in this retreat. Submitting this form is an application, not an acceptance or confirmed reservation. Heather personally reviews every application and will contact you with next steps.

Full name

Email address

Phone number

Preferred contact method

Phone call

Text message

What draws you to this retreat?

Previous retreat, plant medicine, or intensive healing experience

Current physical or mental health considerations, medications, allergies, or accessibility needs Heather should know about

Emergency Contact

Emergency contact full name

Emergency contact phone number

Emergency contact relationship

Anything else you would like Heather to know?

Keep me informed about future classes, retreats, and offerings.

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