*Medical Diagnosis Applicable List: Epilepsy, Heart Condition, High Blood Pressure, Breathing Disorder, Autoimmune Disease, Cancer, Diabetes, any contagious diseases, Glaucoma

I confirm that the information I have provided is accurate to the best of my knowledge. I understand that being open about my physical, emotional, and mental wellbeing helps ensure that any breathwork sessions are safe, appropriate, and tailored to my individual needs.

Breathwork Participation Agreement

By submitting this form, I confirm that:

1. I understand that breathwork may bring up physical sensations, emotions, and personal experiences. Sessions may take place in a group setting and may include guided support from the facilitator.
2. I have provided accurate information about my physical and mental health. I understand that certain health conditions may make breathwork unsuitable or require additional discussion before participation.
3. I accept responsibility for my participation and understand that breathwork is not a substitute for medical, psychological, or psychiatric treatment.
4. I agree to follow all guidance provided during the session and will inform Sharon of any changes to my health or wellbeing that may affect my ability to participate safely.
5. I understand that Sharon reserves the right to decline or discontinue participation if there are concerns about safety or suitability.

By submitting this form, I confirm that I have read, understood, and agree to the above.