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Breathwork Session Waiver & Informed Consent

By completing this form, you confirm the following:

I understand that:

• Breathwork involves conscious breathing techniques that may cause lightheadedness, tingling, or emotional release

• These sessions are not a substitute for medical or psychological treatment

• Arseniy is a breathwork facilitator, not a licensed medical professional

I confirm that I:

• Am 18 years of age or older

• Do not have a history of epilepsy, seizures, cardiovascular disease, or detached retina

• Am not currently pregnant

• Am not recovering from recent surgery

• Do not have a history of severe anxiety, psychosis, or bipolar disorder without professional support

• Will inform Arseniy of any medical conditions or medications before the session

I agree that:

• I participate voluntarily and may stop at any time

• Arseniy is not liable for any physical or emotional discomfort arising from the session

• I take full responsibility for my own wellbeing during and after the session

Participant Information

Full name:

Date of birth

Email

Any health conditions or medications to be aware of?

I have read and agree to the above.

I have read and agree to the above.