The Practice Jon Sessions Private Book →

Registration form.

Before your first session, please take a few minutes to fill this in. It helps Jon prepare the space for you — and keeps everything safe and considered.

First Name*

Surname*

Email Address*

Date of Birth*

Age Group*

Phone Number*

GP Phone Number

Emergency Contact Phone Number*

Do you have prior experience of breathwork?*

YesNo

Do you have experience of spiritual or psychological work?*

YesNo

What prompted you to book this session?*

Are you comfortable with the appropriate use of touch during the session?*

YesNoI'd like to discuss this first

Are you comfortable being worked with on an energetic level during the session?*

YesNoI'd like to discuss this first

Waiver & Informed Consent

I have read and agree to the waiver above*

Yes, I agreeNo, I do not agree

Do you have any medical conditions we should be made aware of?*

YesNo

Health Information to Discuss

Is there anything else you would like to ask or share?

Prefer to fill in by hand?Print version →

Endeepenment

Breathwork Activations · London & online · by Jon Fordhouse · 25+ years.