Our Privacy Policy

Privacy Policy

Ayana Spirit Medicine Sanctuary

Effective Date: 4/24/2025

Ayana Spirit Medicine Sanctuary (“we,” “our,” or “us”) is committed to protecting the privacy and personal information of all clients, participants, and visitors. This Privacy Policy outlines how we collect, use, store, and protect your information in alignment with the sacred and confidential nature of the services we provide.

1. Information We Collect

We may collect the following types of personal information:

Full name, address, phone number, email
Emergency contact details
Medical history and relevant health information (only as provided voluntarily)
Intake and consent forms
Payment and transaction information
Feedback, testimonials, or inquiries you share with us

2. How We Use Your Information

We use your information for the following purposes:

To safely and ethically guide you through ceremonies, sessions, and healing modalities
To maintain records for internal and legal purposes
To contact you regarding your appointments, follow-ups, or service updates
To enhance our offerings and improve the quality of our services
To honor your preferences and spiritual needs

3. Information Sharing and Disclosure

We do not sell, rent, or trade your personal information. Your information will only be shared:

With your explicit consent
If required by law or legal obligation
In a medical emergency, with appropriate professionals, when necessary for your safety

4. Confidentiality of Ceremony and Sessions

All personal experiences shared during sessions and ceremonies are held in strict confidence. We uphold a strong spiritual and ethical boundary to ensure your trust and privacy are protected.

5. Data Security

We implement physical, administrative, and digital safeguards to protect your information from unauthorized access, disclosure, or misuse.

6. Your Rights

You have the right to:

Request access to the personal data we have on file
Request corrections to inaccurate or incomplete data
Request that we delete your information (unless retention is legally required)
Opt out of any future communication at any time

7. Updates to This Policy

We may update this policy from time to time. Any changes will be posted on our website and made available at our sanctuary. Continued use of our services indicates your agreement with the latest version.

8. Contact Us

If you have any questions, concerns, or would like to exercise your rights regarding your personal data, please contact:

Ayana Spirit Medicine Sanctuary

Email: Ayanaspiritmedicinesanctuary@gmail.com

Retreat Intake & Health Waiver

First name

Last name

Phone

Birthday

Month

Day

Year

Address

Weight & Height?

Are you pregnant or breastfeeding?

Are you currently under the care of a physician?

Please list two Emergency contacts, one contact who is aware of your participation in this retreat:

Do you have a diagnosed heart condition

Do you have any known allergies, (including food , plants, medication, insect) ?

If so, are you taking medication? Please list

Do you have a history of Seizure or been diagnosed with a seizure disorder ?

If so, are you on medication , if so please list all medications

Have you been diagnosed with Depression, Anxiety, Schixophrenia , Multiple Personality Disorder or Bipolar?

Have you ever experienced Psychosis ? If so please explain in full details.

Are you currently on any SSRI's or SARI's if so please list all

Are you currently taking any medications (prescriptions or over the counter? If yes, please list all

Do you have a history of addiction, Alcohol, Cocaine ,Methamphetamine, etc?

Are you currently taking any psychotropic drugs, including plant derived?

Are you currently consuming Energy Drinks Dietary supplements Appetite Suppressants

Do you consume caffeine on a daily basis? If so how many cups?

How do you feel your mental state is at this current moment?

Have you had suicidal thoughts, if so when?

What do you wish to change in your world and around you?

RETREAT QUESTION:Have you had previous Entheogenic Journey's? If so how was that experience for you?

RETREAT QUESTION: Are you willing to follow a Dieta for this retreat?

RETREAT QUESTION: Do you commit to respect confidentiality when it comes to this retreat.

RETREAT QUESTION: Can you commit to 3 total integration calls?

RETREAT QUESTION: Do you commit to following all guidelines from your medicine woman, Jaime and her team?

If at any given moment you would like to express yourself, regarding needs or concerns, can you feel comfortable speaking directly to Jaime and her team?

Intentional practice is so important, please share what your intentions are for this upcoming retreat or session.

Medication Disclosure & Safety Policy

For the safety of all participants and facilitators, it is mandatory that you fully disclose any psychiatric medications you are currently taking, including SSRIs (Selective Serotonin Reuptake Inhibitors) and SARIs (Serotonin Antagonist and Reuptake Inhibitors).

If you have been medically advised to discontinue an SSRI or SARI prior to participating in any ceremony, retreat, or medicine-based experience and have not done so, you are placing yourself and others at serious risk.

Combining these medications with ceremonial or altered-state experiences can significantly increase the risk of severe psychological distress, including but not limited to serotonin syndrome, emotional destabilization, dissociation, or psychosis. In some cases, this can lead to unsafe behaviors, loss of grounding, and situations that may put other participants and facilitators in harm’s way.

There is no room for exceptions when it comes to safety. Failure to disclose medication use or to follow medical guidance will result in denial of participation and forfeiture of any deposits or fees.

This policy is not punitive—it exists to protect your well-being, the integrity of the space, and the safety of the collective. If you are unsure whether you are ready to participate, or if you need support in determining appropriate timing, we strongly encourage you to reach out prior to registration.

Your honesty and self-responsibility are essential in this work.

Acknowledgements

By signing below, I acknowledge and agree to the following:

I understand that I am voluntarily participating in a sacred plant medicine ceremony, which may include substances such as [insert plant medicines used, e.g., cacao, hapé, mushrooms, etc.], and that these medicines have both physical and psychological effects.
I have disclosed all relevant medical conditions, allergies, and medications to the facilitator(s). I understand that failure to disclose accurate information could put my health at risk.
I acknowledge that the ceremony and related services are not a substitute for medical or psychiatric care, and the facilitators are not licensed medical professionals unless explicitly stated.
I understand that I am fully responsible for my own physical, emotional, and spiritual well-being before, during, and after the ceremony.
I agree not to hold Ayana Spirit Medicine Sanctuary, its facilitators, volunteers, or guardians liable for any injury, illness, or adverse effects resulting from my participation in this ceremony.

Consent

I have read and understood the information above. I have had the opportunity to ask questions and receive answers. I voluntarily agree to participate and accept full responsibility for my experience.

Date