Breathwork Information Form & Waiver

 

MAKE SURE TO READ THIS DOCUMENT IN ITS ENTIRETY BEFORE BOOKING.

 

What Breathwork is:

Breathwork describes a group of exercises that teach you to manipulate your breathing rate and depth with the goal of bringing awareness to your breath and ultimately providing the same benefits you might get from a meditative practice.

 

Nature of the Services Provided: 

 

Breathwork Sessions:

The client participates in breathing exercises with eyes closed and in a safe position. Do not perform breathwork while driving. You might experience a stress release, emotional release, heightened sense of elation in the body.

 

What you should know about Breathwork:

Breathwork is generally safe when practised with care. However, there are a few cases when it would not be advised to do breathwork; namely for anyone with a known cardiac arrhythmia (including very slow heart rate), a history of heart block, or people taking certain antipsychotic medications. Additionally, some types of breathwork can induce hyperventilation, which can bring on dizziness, chest pain, and pounding heartbeat.

 

**DISCLAIMER:

Check with your doctor before you start a breathwork practice if you have a history of any of the following or are currently taking antipsychotic medications.

 

Breathwork is not recommended if you have any of the following:

● breathing issues

● cardiovascular issues

● high blood pressure

● history of aneurysms

● osteoporosis

● recent physical injuries or surgeries

● severe psychiatric symptoms

● vision issues

 

Theory of Breathwork:

Breathwork is researched intentional breathing techniques that provide a heightened physiological experience and decrease stress on the system.

 

 

Liability Waiver

 

By Booking you Acknowledge and Agree to the Following:

 

All sessions with Karina Jorgensen (SINDSRO) are not intended to be a substitute for professional medical advice, diagnosis or treatment. I am not a licensed physician. Breathwork and meditation are a complement to, not replacement for, services provided by doctors, nurses, and hospitals.

 

Always seek the advice of your doctor or other qualified health provider with any questions you may have regarding medical conditions. Never disregard professional medical advice or delay in seeking it because of your session with Karina Jorgensen (SINDSRO). You acknowledge that we do not provide medical treatment and that you will seek medical, therapy or psychotherapy services, if needed.

 

I understand that I have enrolled in either: Meditation, Breathwork, Mindfulness, Coaching and take full responsibility for the potential after affects of the session.

 

• I hereby affirm that I am in good health and able to participate in this activity. I do not have any physical or mental conditions which would impair my ability to engage in this activity or which would otherwise endanger my health or which would cause any risk of harm to myself. Your participation is optional and you understand that such physical activity has inherent risks.

 

• If you participate in breathwork, you knowingly assume full responsibility for any risk of loss including but not limited to, personal injury, including serious injury, disability, death, or economic losses including but not limited to loss of income, or medical expenses which you may sustain as a result of your participation.

 

• I acknowledge breathwork is not a substitute for any type of therapy. I understand that breathwork can involve dramatic experiences accompanied by strong emotional and physical responses. I understand that I may find breathwork emotionally, and/or mentally stressful. 

 

• I understand that this breathwork is not medically supervised. I have hereby been advised that I should talk to my physician and/or psychotherapist if I have any questions about my physical or mental ability to safely participate in this breathwork. 

 

• If I have chosen not to obtain a physician's consent prior to my participation I hereby agree that I am doing so solely at my own risk. I hereby waive and release Karina Jorgensen (SINDSRO), any employees, associates, representatives, agents, independent contractors and any related entities from any, and all, claims, costs, liability and expense for any injury, loss or damage (including death) whether known, anticipated or unanticipated, negligent or intentional acts or omissions arising from my participation in breathwork.

 

Agreement to this liability waiver will act as your continued agreement to all ensuing sessions, workshops, retreats and/or seminars whether in person, via Zoom or any other video conferencing.