FORMS

Kambo Contraindications Awareness Declaration

Please fill out the following health declaration form in order to participate in our Kambo session.

First Name

Last Name

It is not recommended to give kambo to anyone with serious heart problems or anyone who are recovering after surgery. The reason for this is that the heart rate will increase for about 5 minutes and the heart must be healthy to accommodate this. Kambo is not recommended for pregnant women or women who are breast feeding, people with Addison’s disease, anyone on chemotherapy, or with low blood pressure treated with medication, or the severely ill. Also, Kambo treatment is not recommended for people with current and severe Epilepsy, who've had a brain hemorrhage, who have an aneurysm or blood clots, who take immune-suppressants for the organ transplant. It is not recommended to give kambo to anyone under 18 years unless one is accompanied by a parent with his/her written concent. If you planning to have kambo session be sure you are not on water fasting and haven't had colonic hydrotherapy, enemas, liver flushes or any water-based detox at least 3 days before kambo.

Are any of the contraindications applicable to you?

Yes

Date

Initials

I confirm that the information given in this form is true

KAMBO FROG

FORMS

Kambo Contraindications Awareness Declaration

Please fill out the following health declaration form in order to participate in our Kambo session.

Covid-19 Health Declaration