Informed Consent & Participant Acknowledgment:

(You will either agree to this when signing up from the form online, or sign in person)


At 9D Fusion Breathwork, the safety and well-being of all participants is our highest priority. As part of our commitment to providing a safe and supportive environment, we require all participants to review and acknowledge this Informed Consent & Release Form before engaging in any session.

While breathwork is generally recognized as safe by the medical community and adverse reactions are rare, it is important that you are aware of potential contraindications. Our facilitators are trained to offer modifications when appropriate, which may reduce the likelihood of rare adverse responses. However, it remains your responsibility to determine whether this practice is suitable for you.

If you have any of the conditions listed below, you are encouraged to consult your physician prior to participating. A breathwork session may not be suitable for you if you have the following conditions:

1.Cardiovascular problems,

2. Abnormally high blood pressure,

3. Aneurysms,

4. Epilepsy or history of seizures,

5. Anyone taking heavy medications,

6. Severe psychiatric symptoms especially psychosis, paranoia, or bipolar diagnosis,

8. Osteoporosis,

9. Recent surgery,

10. Glaucoma,

11. Currently pregnant.

Individuals with asthma should bring their own inhaler if they plan on practicing breathwork.

We also recommend that anyone experiencing an emotional or spiritual crisis, or those with mental health conditions who are not currently in treatment or lack sufficient support, refrain from attending.

Please note that this list is not comprehensive. If you have any concerns about a condition not mentioned here, we advise you to consult with your healthcare provider prior to participating in the breathwork sessions.

I warrant and represent that I am in good health physically, mentally, psychologically and emotionally, and I understand and warrant that if I am not in good health, I should not perform these activities or breathwork sessions. Accordingly, the declaration and certification that I am in good health in all the above-mentioned respects constitutes a material agreement to allow me to participate in the breathing sessions. By participating in sessions, I acknowledge and accept full responsibility for my well-being during and after the session.

I know and acknowledge that the person facilitating is not a doctor or psychiatrist, or a specialist in health care, and that the activities offered are not intended to treat and diagnose specific medical conditions, whether physical, psychological or emotional. I voluntarily participate in these activities knowing the risks and consequences and agree to assume all consequences, known or not.

I release 9D Fusion Breathwork Facilitator: Stephanie Girardi and any partnering businesses, owners or personnel from all responsibilities, costs and damages that may arise from participating in the above-mentioned activity. I agree to accept financial responsibility for costs related to treatment. I acknowledge that I have read the above warning and agree to proceed with full responsibility and understand that I have waived certain rights, and I have agreed to this release of liability freely and voluntarily without any external influence.

 

Important Information

✅ Avoid heavy meals/alcohol a couple of hours before the session (light meal is fine).

✅ Bring something to drink — you may get thirsty during the breathwork.

✅ Think comfy — Bring a small pillow/light blanket, & wear something comfortable.

✅ Arrive a few minutes early — to settle in and not feel rushed.