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Research Registration

Study 1

Register Form for participation in a scientific research

on the Physical and Physiological effects of Breathwork

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you are in good health 

you live in Amsterdam and/or can physically attend one session 

your age is between 20-35

Thanks for your interest in wanting to taking part in this Scientific Research. This is an initiative of Open Up and is conducted in collaboration with Vrije Universiteit of Amsterdam. These questions will inform us if you are suitable for undertaking a breathwork session in this study, and allows us to contact you if needed.

  • Pregnancy
     

  • Cardiovascular problems
     

  • Heart attacks or a history
     

  • High or abnormal blood pressure
     

  • Asthma
     

  • Glaucoma
     

  • Osteoporosis
     

  • Recent surgery of physical injury
     

  • Epilepsy or a history of seizures
     

  • An active addiction

  • If I have or have had any significant mental health challenges in my life. (Any psychotic episodes, depression, anxiety, PTSD or relevant life events)

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  • If there is a history of psychosis, schizophrenia or bipolar disorder in my family?

Corona Symptoms

Are you currently suspected from or diagnosed with cold, pneumonia or Covid-19 infection?
Did you have any of the following symptoms in the past 48 hours

Covid Protocol Agreements *

Privacy statement

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Thank you for taking the time to answer our questions. They are designed to help us best serve you in the our research. All answers are entirely confidential, so the information you provide to us will not be shared with other participants or anyone outside the Open Up and VU team. Your data is held for the purpose of evaluating your suitability for this research and is not passed on to anyone outside of the Open Up and VU organisation.

Thank you for your openness and for taking the time to

answer our questions.

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