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The Matter
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Thank you for signing up for an event with us. Would you like to fill in some details?

First name *

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Zipcode *

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By signing up you agree to the privacy policy of The Matter.

We have a few more questions for you, so that we can get to know you a little better and guide you as well as possible.

Event ID *

Event *

First name *

Last name *

Company

Email *

Phone *

Date of birth (dd-mm-yyyy) *

Streetname + number *

Zipcode *

City *

Do you have experience with psychedelics? *

If so, which and when was the last time? *

How has/have your experience(s) been with psychedelics? *

What is the reason you are registering for this retreat? *

What would you like to know, find out, learn, process? *

Do you ever use mind-altering drugs? *

Yes, that is: *

Are you currently taking any medications? *

Yes, that is: *

Do you suffer from psychological problems? *

Yes, that is: *

Do psychological problems run in the family? *

Yes, that is: *

Do you suffer from heart problems or high blood pressure? *

Are you pregnant or are you breastfeeding? *

What is your primary response to fear? *

What helped you the most at such a moment? *

Which loved ones that are important to you have passed away? *

What events in your life have left a deep impression on you? *

What are recurring patterns that hinder you? *

Can you tell us something about your background? *

Think of family, upbringing, what did you get from home

Are there recurring themes in the family line? *

Think health / family patterns / traumas / problems

Food-wise: what do you like to eat? *

Something you can really enjoy

And what would you rather not eat? *

Allergies, diet or conscious choices

Is there anything else that is good for us to know? *

What can help us make your experience as pleasant as possible for you

How did you find us *

Other: *

Confirm *

I have answered the above questions truthfully.

By signing up you agree to the privacy policy of The Matter.

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