Ayahuasca Experience Questionnaire
Share your experiences with Ayahuasca to help us better understand its impact. No sensitive or identifying information will be collected.
How did you first learn about Ayahuasca?
*
Please Select
Friends or family
Online resources
Books or documentaries
Retreat center
Other
How many Ayahuasca ceremonies have you participated in?
*
Please Select
1
2-3
4-6
7 or more
What was your primary motivation for participating in an Ayahuasca ceremony?
*
Please Select
Personal growth
Healing or therapy
Spiritual exploration
Curiosity
Other
Did you experience any of the following during your Ayahuasca ceremony? (Select all that apply)
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Visual effects
Emotional release
Physical sensations
Spiritual insights
Challenging experiences
Other
How would you rate the overall impact of your Ayahuasca experience on your life?
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1
2
3
4
5
What positive changes, if any, have you noticed since your experience?
Did you experience any challenges or negative effects? If so, please describe.
Would you recommend Ayahuasca to others?
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Yes
No
Not sure
What is your age range?
*
Please Select
18-24
25-34
35-44
45-54
55 or older
Which country do you currently reside in?
Submit
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