Finding comfort & ease with your breath

Name *

First Name

Last Name

Phone *

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Date of Birth *

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YYYY

I agree that the information I've provided is accurate, and I understand this is no substitute for medical advice or treatment. *

I confirm that all to the best of my knowledge all the information provided in this form is accurate and up to date. I understand that our sessions may involve physical movement, breathing, and meditation, which induces specific physiological and psychological changes. I represent that to the best of my knowledge and belief, and I can participate in these activities as mentioned above. If I am unsure or have questions regarding these practices, I will speak to my doctor and Laura Campbell to receive further counsel and follow her advice. I understand that breathwork does involve movement and that, like with any physical practice, in the unlikely event that injury occurs, I will not hold Laura Campbell liable. I hereby assume full responsibility for any risk or injury arising out of or related to my participation. Whilst it can be hugely beneficial, I know that yoga therapy, meditation, and breathwork are not substitutes for any care I may be receiving from a professional primary health care provider. It is advisable to continue any therapy work in conjunction with breathwork. I fully understand that any practitioner or therapist recommended to me, or to whom I am referred, by Laura Campbell is not an employee, agent, or affiliate of Laura Campbell; or Laura Campbell is liable for any act or omission of any such practitioner or therapist. I understand that I am responsible for notifyingLaura Campbell of any changes to my health or medical conditions that may affect the treatment carried out by my breathwork facilitator

I agree