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Trauma-Informed Breathwork Facilitation Training
Submit your application of interest
to enroll for the 2026 program and join our community of facilitators. This will be a year-long advanced facilitator certification. All information is confidential and used solely for applicant assessment.
Full Name
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Email
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Date of birth
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Phone (WhatsApp)
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City, Country
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How did you hear about this training? (Instagram, someone you know etc.)
Socials Handle- (Insta, Linkedin etc.)
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Have you previously experienced Conscious Connected Breathwork?
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Have you previously experienced Conscious Connected Breathwork?
A
I am familiar, I practice regularly
B
I've tried it a few times
C
No, I'm new to Breathwork
Do you currently work in a space that involves supporting others?
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Do you currently work in a space that involves supporting others?
A
Yes (coaching, therapy, Yoga, bodywork, facilitation, etc.)
B
No, but I have in the past
C
No
If yes, briefly describe your work:
Do you currently have, or have a history of, any of the following?
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Do you currently have, or have a history of, any of the following?
Cardiovascular conditions (e.g. heart disease, high blood pressure)
Respiratory conditions (e.g. severe asthma)
Epilepsy or seizures
History of psychosis, schizophrenia, or bipolar disorder
Severe anxiety, panic disorder, or PTSD
Recent surgery or physical injury
Pregnancy
None of the above
If you selected any of the above, please provide relevant details:
Are you currently taking medication that affects your mental or emotional state?
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Are you currently taking medication that affects your mental or emotional state?
A
Yes
B
No
If yes, please briefly share:
What is your primary intention for joining this training?
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On a scale of 1–10, how ready are you to step into deep personal and professional growth?
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On a scale of 1–10, how ready are you to step into deep personal and professional growth?
1
2
3
4
5
6
7
8
9
10
What next?
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What next?
A
Please send me the full Brochure
B
I have the brochure and I want to learn more
C
I'm ready for a discovery call
Submit
