Thank you for your interest in a Well Warrior Breathwork session. Please take a moment to complete this form.

Please note this form is for clients who have pre-booked a session. If you have not booked a session please do not complete this form. To book a session please send a message via Facebook or Instagram. Alternatively contact Dane on 0497 015 880.

This form is an agreement between yourself (the client) and Well Warrior for the duration of your time using Well Warriors services. You will always be under the terms of this agreement until you cease doing breathwork. Should you cease breathwork for longer than 6 months this form will need to be completed again.

This form applies to all breathwork sessions both in person and online.

Full list of Terms & Conditions can be found at www.wellwarrior.com.au

Which breathwork session have you booked in for? *
 +

During a breathwork journey, we will be exploring the power of our breath. Breathwork is a safe personal growth experience designed to enhance the quality of life and may involve strong connected breathing and guided meditation which can result in emotional and physical experiences.

As a part of the practice, you will experience breath holds after inhale and breath holds after exhale therefore if you experience any of the following it is strongly recommended to not participate in the breath holds:

- Acute, severe or virus illness

- Epilepsy

- Cardiovascular conditions (arrhythmias, high blood pressure, pacemaker, heart attack, angina, heart disease)

- Pregnancy

- Tinnitus

- Hernias

- Lung and chronic obstructive pulmonary disease (COPDII & COPD-III)

- Chronic disease, organ failure or terminal illness

- Intolerance of oxygen insufficiency

- Cold, flu or fever

If you experience any of the contraindications above, or any other medical condition not listed, and still decide to participate in the breath holds and breathwork in general, please know you do so at your own risk.

It is recommended that you gently include breath holds to improve your health as it is always safer to build up your tolerance slowly and steadily. If at any time you feel uncomfortable during a breath hold simply return to your normal breathing. Always listen to your body.

Should you have any questions regarding contraindications or breathwork please contact Well Warrior or your healthcare provider.

This screening tool does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No warranty of safety should result from its use.

I agree to the above information and Terms & Conditions here *
By signing below you acknowledge you have read, understood and agree to this Breathwork Waiver and that all the information you have provided within this form is correct. *
clear
 +
How did you hear about Well Warrior? *
 
Powered byFormsite