Interested in a Personalized Retreat?

Interested in working together? Fill out some info and we will be in touch shortly! We can't wait to hear from you!

Collage of relaxing home scenes: a woman sitting on a couch, hand massage, wooden board with snacks, woman on an orange sofa, a person using a phone with candles in foreground, a person meditating by a window, and a wooden figurine.

Name

First Name

Last Name

Phone

(###)

###

####

Preferred Date

requested date to start retreat

YYYY

How many are in your party?

Are you interested in a particular focus or theme?

Medical Info

Does anyone in your party have any daily prescription medications, medical implants or serious mental or physical health conditions? Please briefly explain:

Traveling?

Are any in your party traveling from outside of the Bend, OR area?

Thank you for your interest!

We will review and reach out to you shortly to schedule a consultation. Please note below any additional information you believe we should have.

Interested in a Personalized Retreat?

Myco-Vision

Psychedelic Ceremonialist & Advisor