BREATHING QUESTIONNAIRE

Complete this questionnaire, and email it back to me a week before your first session. The more care you take with it, the more I will be able to address your individual needs.

Please skip questions that don’t feel relevant, and don’t reveal anything you don’t want to reveal.
I will keep the information you share confidential.

Name

First Name

Last Name

Why do you want coaching?

How did you hear about Saul Kotzubei? If there was anything specific that interested you initially, what was it?

What prior study of breathing, if any, have you had?

How did that training work for you?

What prior bodywork/exercise/sports/meditation training, if any, do you have?

How did that training work for you?

Do you have any injuries or conditions that might restrict what you do?

Examples: I twisted my knee 6 months ago and it only hurts rarely now. I tend to have generalized lower back pain. I get panic attacks. I was in a car accident last week and my neck is a little sore. I have TMJ/vocal nodules/asthma. I struggle with depression and prefer not to be emotional. I am pregnant.

Have you seen a medical doctor, therapist, or anyone else for the conditions you mention above? If so, what advice were you given?

Have any of the conditions mentioned above had a lasting impact on your breathing, your voice, your sense of presence, your creativity, or your ability to communicate?

What do you like or enjoy about your breathing?

Is there anything related to your breathing that you feel limits you or that might prevent you from realizing your personal or professional goals?

Do you have any complaints about your breathing not mentioned above? If so, do you experience them directly, or do they come from other people?

Do you have any positive or negative personal experiences, learned behaviors, or beliefs that you feel affect your breathing, your presence, or your ability to communicate with others in general or your ability to communicate in specific situations?

Do you have any concerns about working with me on your breathing?

Is there anything you want to add?

Voice, Public Speaking, & Presence Coach Saul Kotzubei

Voice, Public Speaking, & Presence Coach Saul Kotzubei

Breathing Questionnaire Test Page (OT) (Copy)

Voice, Public Speaking, & Presence Coach Saul Kotzubei

BREATHING QUESTIONNAIRE

Voice, Public Speaking, & Presence Coach Saul Kotzubei