Your First and Last Name (*required) Your Email (*required) Name of Church 1) Have you had Ayahuasca seized in 2020? YesNo 2) What was the date, or date range, of your latest seizure. 3) Did you receive an empty original-shipping-box with a notice from Home Land Security referencing the seizure? YesNo 4) Was this Ayahuasca in solid-tar or liquid form? Solid-TarLiquid 5) Have you received shipments in prior years? YesNo 6) Have you had Ayahuasca seized in prior years? YesNo 7) Have you had prior seizures of your sacrament? YesNo 8) If so what are the dates, or date ranges, for those shipments? 9) Have you had multiple seizures in 2020? YesNo 10) If so, how much? 11) Are you currently a member of NAAVC? YesNo 12) Were you a member of NAAVC at the time of the seizure? YesNo 13) Is your use of Ayahuasca part of your spiritual and religious practice? YesNo 14) County and State where the seized Medicina was mailed 15) Additional notation or comment Upload any images of the notice you received from Customs or Home Land Security following seizure. For further inquiry contact us at action@NAAVC.org.