This liability waiver is between the participant and PSYEED LLC.
This document must be completed and signed before your first 9D Breathwork session with Psyeed, LLC. It is required without exception and must be submitted prior to participation. This form remains active for the duration of your time with Psyeed, LLC. If anything changes since you first completed it, you are required to notify Psyeed, LLC at [email protected] before your next session. Silence is understood as confirmation that everything remains the same and all answers remain accurate and current.
For those electing to participate solely in 9D Breathwork and not in a Psyeed Method™ program, this document serves as your standing agreement. Completion of this form does not create a therapist–client, doctor–patient, or any other professional–client relationship.
We prioritize the safety, care, and well being of all participants. As part of our commitment to providing a safe and supportive environment, completion of this Liability Waiver and Informed Consent Form is required prior to participation in any breathwork session.
9D Breathwork is a guided breathwork experience combining conscious connected breathing techniques with immersive multi-dimensional audio, including music, binaural beats, solfeggio frequencies, subliminal affirmations, and guided visualization. All sessions are conducted virtually via Zoom. Sessions are facilitated by Psyeed LLC through Stephanie Kole, a Certified 9D Breathwork Facilitator. This certification qualifies Stephanie Kole to guide clients through the 9D Breathwork experience in a coaching and educational context. 9D Breathwork facilitation is not a licensed medical or therapeutic modality and Stephanie Kole does not hold a clinical license in connection with breathwork services. The activities offered through this program are not intended to treat or diagnose any medical, psychological, or emotional condition of any kind.
9D Breathwork as facilitated by Psyeed, LLC is an educational and experiential awareness modality offered within the scope of coaching. It is NOT:
Medical treatment, medical advice, or a substitute for medical care
Psychotherapy, counseling, psychiatric treatment, or any form of licensed mental healthcare
A diagnostic tool or treatment for any physical, psychological, or emotional condition
A crisis intervention service
I understand that the facilitator is not a physician, nurse, psychiatrist, psychologist, psychotherapist, licensed counselor, or any other licensed healthcare or mental health professional. Nothing communicated during any breathwork session constitutes medical, psychological, or therapeutic advice. I am solely responsible for consulting with licensed professionals regarding any medical or mental health concerns before, during, and after my participation.
By signing this document, I represent and warrant that I am in appropriate physical, mental, psychological, and emotional health to participate in 9D Breathwork. I understand that if it is determined that I am not in suitable health, I may be restricted from participating. This declaration of good health is a material condition of my participation.
I understand that any misrepresentation or omission of material health information on this form, or during a pre-session verbal health check-in, releases Psyeed, LLC from any liability for adverse outcomes arising from a session conducted based on my incomplete or inaccurate disclosures. I agree to respond honestly to pre-session verbal health check-ins before each breathwork session.
I voluntarily choose to participate in breathwork sessions with full knowledge that breathwork may involve physical, emotional, and psychological risks. I knowingly and willingly assume full responsibility for any and all risks, known or unknown, associated with my participation.
If at any point during a session I experience chest pain, difficulty breathing that does not resolve, severe dizziness, loss of consciousness, or any symptom that feels like a medical emergency, I will STOP IMMEDIATELY and call 911.
I authorize Psyeed, LLC and its representatives to contact emergency services, and my emergency contact, on my behalf if the facilitator determines an emergency may be occurring during a session or has reasonable belief that I may have lost consciousness. I understand and agree that I am solely responsible for all costs associated with any emergency medical treatment arising from my participation.
To the fullest extent permitted by law, I hereby release, waive, and discharge Psyeed, LLC and each of its direct and indirect parent companies, subsidiaries, affiliates, member entities, managers, owners, officers, employees, contractors, agents, successors, assigns, volunteers, and where applicable, venue owners and event facilitators, from all liability, claims, demands, costs, or damages of any kind, including physical, emotional, psychological, or spiritual, arising from or related to my participation in any 9D Breathwork session facilitated by Psyeed, LLC, whether conducted virtually or in person, except in cases of gross negligence or willful misconduct by the Company.
I acknowledge that this release was a material condition of my participation and that Psyeed, LLC would not have permitted my participation without it. I agree to assume and accept full financial responsibility for any medical or therapeutic treatment that may be required as a result of my participation.
I further acknowledge that virtual sessions depend on internet connectivity, audio equipment, and third-party software, and that these may fail, degrade, interrupt, or disconnect at any point during a session, including mid-journey. I accept technology failure as a risk of participating virtually and release the parties named above from any liability, claim, or demand arising out of or related to it.
Psyeed, LLC does not ask for a list of medications and does not require health intake details. It is my responsibility to read the Safety Guide & Contraindications, to comply with the guidance in it, and to consult my physician.
Psyeed, LLC is not a HIPAA-covered entity. Anything you choose to share through this form or in session is not protected health information under HIPAA, and is handled under the Terms & Policies at psyeed.com.
This form is a living document. I understand that my obligation to disclose relevant and circumstantial information does not end upon submission of this form. I agree to notify Psyeed, LLC at [email protected] before any session if:
Any health information I have voluntarily chosen to disclose to Psyeed, LLC has changed
I have received a new diagnosis that may affect my ability to safely participate
I am experiencing acute emotional, psychological, or spiritual distress
No update from me is understood as confirmation that all previous answers remain accurate and current and that I am in suitable condition to participate.
This Liability Waiver is governed by the laws of the State of Utah. Any dispute arising from this document shall be resolved in accordance with the dispute resolution provisions of the Psyeed, LLC Service Agreement where applicable. This document is incorporated into the Psyeed, LLC Service Agreement by reference where a Service Agreement exists between the parties.
Booking: Appointments can be scheduled via our online booking system.
Confirmation: All appointments must be confirmed at the time of booking. Participants will receive a confirmation email or text message with the appointment details.
Payment: Payment for sessions is due at the time of booking. We accept all major credit cards and electronic payment methods.
Cancellation Notice: Participants must provide at least 24 hours’ notice for cancellations or rescheduling. This can be done through our online booking system, by phone, or via email.
Late Cancellations and No-Shows: Appointments canceled with less than 24 hours’ notice, or if the participant does not show up for the appointment, will be charged the full session fee. This policy ensures that our practitioners’ time is respected and that we can offer the appointment slot to another participant in need.
Emergency Cancellations: We understand that emergencies happen. If a cancellation is due to an emergency, please contact us as soon as possible to discuss the situation. We may waive the cancellation fee at our discretion.
Refunds: No refunds will be given for late cancellations or no-shows.
Credits: If a session is canceled with proper notice (24 hours or more), the participant may choose to reschedule the session or receive a credit toward future sessions.
By scheduling an appointment with Psyeed®, participants agree to the terms outlined in this policy. This policy is in place to ensure fairness and to maintain the quality of service for all our participants.
By signing below, I confirm and acknowledge each of the following:
I have read this entire document and understand its contents.
I have read and understand the Safety & Contraindications Guide.
I have answered all questions truthfully and completely.
I represent and warrant that I am in appropriate physical, mental, psychological, and emotional health to participate in 9D Breathwork.
I understand that 9D Breathwork is not therapy, medical treatment, or any form of licensed healthcare.
I understand that the facilitator is not a licensed medical or mental health professional and that the activities offered are not intended to treat or diagnose any condition.
I voluntarily assume all risks associated with participation in 9D Breathwork sessions.
I understand that breathwork can bring up physical sensations, emotions, memories, or insights, and I agree to pace myself, modify, or stop if needed.
I understand that I am never required to share verbally during or after the session unless I choose to.
I agree to respect the privacy and confidentiality of other participants and to refrain from sharing others’ experiences without consent.
I understand the virtual session environment requirements and limitations, and agree to comply with them for every session.
I understand the risks and limitations if I choose to participate with my camera off.
I will not participate in any session while under the influence of alcohol, cannabis, recreational drugs, or any other mind-altering substance.
I understand that I am solely responsible for notifying Psyeed, LLC before any session if there are material changes.
I understand that silence is understood as confirmation that my previous answers remain accurate and current.
I have read and agree to the Psyeed, LLC Service Agreement and Terms & Policies at psyeed.com.
I am at least 18 years of age and have the legal capacity to sign this document.
I understand that this document was a material condition of my participation and that Psyeed, LLC would not have permitted my participation without my agreement to its terms.
By signing below, I acknowledge that I am waiving certain legal rights, and that I am signing this agreement freely and voluntarily, without coercion or undue influence.