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9D Breathwork is an immersive sound experience that deepens your breathwork experience for Healing, Empowerment and Success.Radical transformation that helps you improve your Human Experience. 9D Breathwork is leading the way by combing ancient practices with cutting edge technology along with the love, coaching and support that Ben and Cassy Dickerson provide.
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Full Name:* This field is required.
First Name
Last Name
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Company Name if applicable
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E-mail:* This field is required.
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Phone Number* This field is required.
Country Code
Phone Number or what's app no
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Your Location
Suburb
State
Country
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Have you experienced a guided Breathwork over an hour before ?
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What services are you interested in
Breathwork Coaching in our Sunshine Coast Studio
Breathwork Coaching Via Zoom
Group Breathwork at your Venue for your Clients
Breathwork at your company to improve the wellness of your Employees
Breathwork Facilitator Training
Online Breathwork Program for Better Health
Key note Speaker / Presenter
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Do You need Help with any Physical Issues Breathwork can Help
Pain Management
Sleep Issues
Enhanced Immune Function
Respiratory Conditions
Enhanced Physical Performance
Addiction Recovery
Lowered Blood Pressure
Improved Digestion
Breathing Problems like Asthma
nervous twitch
other - u can write below
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Do You need Help with any of the following that Breathwork Improves
Stress Reduction
Improved Mental Clarity
Anxiety and Panic Attacks
Depression
Habit Change
Creativity and Inspiration
Spiritual Growth
Self-Awareness:
Trauma Healing
Self Love
Coping with Grief
Forgivness
Relationship improvement
Letting Go
Other
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What are you are struggling with most in your life right now ? Something you would like to let go of.
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What is one thing would you like to call more of into your life right now ?
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Do you have any of the following medical conditions ? Currently on heavy medications, severe psychiatric symptoms, bipolar, depression, Osteoporosis, Asthma, experiencing an emotional or spiritual crisis, cardiovascular problems, high heart rate or blood pressure, History of epilepsy or Seizures , history of diagnosed mental health issues. Pregnant. If you have any of these please give a brief details below otherwise just comment with NO in the box below.
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Release of Liability, Waiver and Assumption of Risk AgreementYou authorise Release of Liability, Waiver and Assumption of Risk Agreement In consideration to participating in the Breathwork session conducted by Breathe and Connect. I, hereby acknowledge, understand and expressly agree as to the following: (1) Breathwork can result in intense physical and emotional release Therefore, it is not advised for persons with a history of cardiovascular disease, including angina or heart attack, high blood pressure, use of a pace-maker, glaucoma, retinal detachment, osteoporosis, significant recent physical injuries or surgery. (2) Breathwork is not advised for persons with severe mental illness or seizure disorders or for persons using major medications. It is also unsuitable for anyone with a personal or family history of aneurysms. (3) Pregnant women are advised to let the facilitators know you are pregnant prior to the session so a modified breathing technique can be given. We also recommend consulting and getting approval from their primary care physician. (4) Persons with asthma should bring their inhaler and consult with their primary care physician and the Breathwork class facilitator.
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Thank You for completing the information. Please Book a time for your discovery call
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We look forward to speaking with you soon Ben and Cassy
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