
Non-Medical Supervised Water Fast Intern Application
January 30th - March 13th 2027 **includes arrival and departure days
To get started with the Application for the "Detoxification, Cleansing, and Healing in Costa Rica" with Dr. Douglas Graham, D.C., please enter all your details and click the "Fill Out Application" button.
Spots for this event are extremely limited and will be allocated on a first-come, first-served basis for completed applications.
After you complete your application, Dr. Graham, D.C., must still approve it.
We will notify you when your application is approved and send you the payment link.
Your deposit payment must be received before your spot at the event is reserved.
Please fill out the form fully and completely to the best of your ability. Being honest and open is certainly the best policy in this regard, as it helps us get to know you better.
Depending on your answers, we may have more questions. Once your application has been reviewed, we will get in touch with you.
Thank you for your interest in joining us at the Fasting and Feasting in Costa Rica with Dr. Graham.
Terms and Conditions: Due to the sensitive nature of this event, interns may be asked to leave if they are
becoming a disruption to the group. If such a situation occurs, and an intern cannot follow the rules and
regulations set forth by Dr. Graham and his staff, which results in that intern being asked to leave (which is at the sole discretion of Dr. Douglas Graham), the intern will not be entitled to a refund of their expense.
IT IS CRITICAL THAT YOU ANSWER ALL QUESTIONS FULLY AND TRUTHFULLY! Make sure you have all the information before you start filling out this form.
NOTE: All fields marked with an asterisk (*) are required.
You cannot submit this form without filling in all required fields, and it will not save a partially filled application's information. If you are not able to complete and submit this form, you can click to apply again in order to start again when you are ready.
Once Dr. Graham, D.C. has reviewed your application, he will contact you at the email address you provide below. If accepted and there is still space left, you will be provided with payment details.
Contact Info for Intern
Choose a country (click the country below to choose another if needed)
Personal Info for Intern
Goal and Background
Special Needs of Intern
Emergency Contact Info
Those to contact in case of intern's emergency while attending (you must specify at least one emergency contact):
Additional Info