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Breathwork - WAIVER

This waiver is for all our health and saftey needs. If you have breathed with me within the last 12 months you only need to fill out one per year or if you have had any changes to your health.

Any questions regarding contraindications, please do get in touch.

IMPORTANT: You will not be able to experience a full conscious connected breath if you have any contraindications listed below, however I can offer you a modified, gentler format instead.

Date of Birth
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This breathwork practice has some limitations to the open mouth Conscious Connected breath technique. If you have any of the following we would breathe through the nose. Do you have any of the following contraindications?

In any of these cases, modified practice options may be offered to you. We also advise modified practice if you are experiencing panic attacks and high levels of anxiety at present.

Please advise your facilitator if currently using micro-dosing protocols.


The facilitator may on occasion advise that breathwork is not suitable for you.


Your agreement: Whilst I have been accepted as a participant for this session, I accept responsibility for any consequence resulting from this practice.


Your breathwork facilitator is not asubstitute for consulting your GP or primary medical care provider.


In the event of any known medical conditions, I certify that I have consulted a health professional regarding any condition (physical, mental or emotional) that could interfere with my judgment or affect my health in any way during, or after the session.

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