Pre Breathwork Questionnaire & Waiver

IMPORTANT:
PLEASE READ THIS PAGE THIS BEFORE ATTENDING A CONSCIOUS CONNECTED BREATHWORK SESSION

Presented by ADRIAN RAMBLA,
Founder & CEO aT RAEMBLA

I will guide you through a transformative journey that will help you to release trauma, blockages and low vibrational energies stored in your body.
It will expand and increase your energy bringing a total awareness and bliss

Conscious Connected Breathwork

Health Waiver and list of Medical Conditions which may be

Contra-indicated

Conscious Breathing

A Conscious Connected Breathwork session can range an incredibly powerful trauma release experience to a gentle and euphoric session, depending on what is present and alive for the breather on the day.

All emotions are welcome within the context of the Breathwork Session becoming a supportive container for the processing and expression of emotion through the body, via the breath.

At times, some of the more challenging emotions such as sadness, grief, anger or fear may arise, and other times feelings such as deep bliss, ecstasy, and joy may wash through the body, as the breath works its innate intelligence into the awareness of each present moment.

Co-Creating a Supportive Container for Breathwork

In order for us to be able to hold a safe container for you, it is important that we come into agreement on the matter of self-responsibility. It is also important that we know if you have any health challenges, be they physical, mental emotional etc.

The Conscious Connected Breathwork technique is a dynamic somatic breathing practice, and it is important to recognise that it is not an 'everyday' practice, and it is not for everyone.

Its also important to understand that in some cases, a more modified form of practice may be advised, or even a recommendation to seek medical advice before engaging in a session.

The following Health Waiver includes a list of contra-indications which may effect the way in which the technique is practiced. It is important to practice CCB with the support and guidance of a qualified Conscious Connected Breathwork Facilitator in order for a supportive container to be created.

The Technique

The inhalation or ‘in-breath’ is active, and the exhalation or ‘out-breath’ is passive. There is no pause between breaths, which helps the breather stay connected to the breath.

It is usually practiced with an open mouth, unless contra-indicated, in which case a gentler form of the practice may be practiced by breathing through the nose. Please read and agree to having read the health waiver information, before you join a session. The techniques will be demonstrated at the beginning or the session.

CONTRA-INDICATIONS & HEALTH WAIVER

I understand that if I am taking any medications or have any medical conditions such as the

contra-indications below, but not being limited to the following , then I will either regulate my practice or seek advice from a relevant health care professional:

contra-indications

Untreated PTSD
Lung Conditions such as COPD / Severe Asthma
Long Covid Symptoms (please inform the facilitator
Glaucoma
Epilepsy
Bipolar
Psychosis
Schizophrenia
Heart Conditions
Delicate or Early Pregnancy (first trimester)
High/very low blood pressure with fainting history
Recent Major Surgery (within the past 12 months)

If I have a relationship to any of these conditions, and I am unsure as how to/ or whether to practice this technique:

I will, inform the facilitator of my condition before the breathwork or message in a private message, and if I am unsure as to whether to practice the mouth breathing form of this practice, or if I am unsure as to whether this practice is appropriate for me at this time.

I will regulate my breath by breathing more slowly, lengthening the exhale, and or breathing in and out through the nose, so that my nervous system is supported during the practice.

I also understand that even though I have been accepted as a participant, I am responsible for any consequence resulting from this breathwork session.

I understand that Conscious Connected Breathwork is NOT a substitute for consulting my GP or medical care provider. In the event of known medical conditions, I certify that I have consulted a health professional regarding any condition (Physical, mental or emotional) that could interfere with my judgement, or affect my health in any way during or after the session.

It is also important to create a safe and confidential space for you and others (if in a group setting) so we ask that you agree to keep a confidential space and not share anything which has been shared (aside from your own process) outside of the session. It is also important to create a private space where you will not be disturbed, if working online in the privacy of your own home. Please be mindful of this both for yourself and for others on the online call. Headphones are ideal for this practice as it is offered with musical accompaniment.

I acknowledge that the breathwork session is a safe and confidential space, and I therefore agree not to share anything (aside from my own process if needs be)outside of the session.

I have read this waiver and by clicking on the link below, I confirm that I take full responsibility for my own health and wellbeing.