Membership Evaluation Form

Equivalency Training Credits
This form is for documenting training credits earned outside of the initially submitted application. It is intended for applicants who have already applied but need to provide additional training hours to meet the program requirements.

Membership Requirements (please read before completing the form below):
Total Training Curricular Hours Needed for Membership:
Ethically Compliant: 50 hours (including 8 hours of Ethics)
Professional Practitioner: 400 hours

Total Months of Training Needed for Membership:
Ethically Compliant: 9 months
Professional Practitioner: 24 months

of Date training

Your Name *

Date *

Date of your original GPBA membership application: *

Type of equivalent training experience in which you engaged: *

Supervised Teaching: Teaching or co-teaching breathwork students, either in person or online, under the sponsorship of an established breathwork school or trainer.

Supervision or Mentoring: Supervising or mentoring breathwork students or clients, either in person or online, under the sponsorship of an established breathwork school or trainer.

Individual or Group Sessions: Conducting sessions that are reviewed, co-conducted, or supervised by an established breathworker or trainer.

Other Relevant Experience: Include any other experience directly related to your training as a breathwork practitioner.

Hours of engagement over dates (approximate if necessary):

Accumulated months of training experience:

Name(s) of supervising or monitoring breathworker or trainer:

Location of experiences:

Membership Evaluation Form

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