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Participant area · restricted access

Health, personal-history and safety questionnaire

This questionnaire is part of the care process before participation. Complete it only after receiving guidance from a Sanctuary director.

Before you begin

Set aside time and answer honestly.

The form asks for identification details and information about your health, medication, emotional preparation and religious background. We use it for safety screening, the interview, participation planning and support in an emergency.

The experience may be intense and may affect the body, emotions, thoughts or spiritual life in different ways. Completing the form does not guarantee participation and does not replace medical or psychological assessment.

If anything in the form is unclear, please do not guess. Ask the leadership team for help in English before submitting it.

Open the secure questionnaire in Google Forms

The questionnaire is renewed every January and must be updated sooner whenever relevant information changes.