Registration form: Breathwork with Tru Breath        ~ April & May ~
Pre-session information questionnaire.

As you sign up for our Breathwork experience, please fill out the following questions.
Keep in mind, all information that is shared here is for registration requirements and understanding if there are any medical conditions before participating in a group session.
All information is strictly confidential and will not be shared with 3rd parties.

If you have any personal questions, please feel free to send them to the number or email below.

Event dates:
This will be the schedule for April and May - If you wish a one on one session or to orgainise a group session with friends, family or colleagues, please contact me.

Price:
45 euro per session

*For anyone that has fallen on hard times financially, If you feel like breathwork can help you in your healing journey, please contact me and we can arrange a discount that will suit your budget.

Once registered you will receive a confirmation email with more information on the session you signed up for and the payment possibilities. 

Please choose from 1 or more dates in the question box here under

Contact us at +32(0)476701355 or christina.velzeboer@gmail.com
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Email *
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Name *
Email *
Are you above 18? *
Have you any experience with Breathwork? *
Are you on any prescription medication? *
Are you pregnant? *
Do you have high blood pressure, cardiovascular diseases, a detached retina or glaucoma, epilepsy or thyroid conditions? *

Do have a history of strokes, seizures, or aneurysms?

*
Have you been diagnosed with any psychiatric conditions? *
Do you have any other medical, psychiatric, or physical conditions which could impair or affect your ability to engage in activities involving physical and/or emotional release? eg. complex PTSD, recent accident or broken bone, etc.
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