top of page

Client Intake Form

Please fill out the following form to help us understand your physical condition.

What health issues are you looking to get support with during our sessions?
Are you currently getting additional support?
How is your Sleep?
How is your digestion?

Thanks for submitting!


Breathwork isn't just for Freediving! This can help with common Breathing Dysfunctions. 

1hr Breathwork - via Zoom

1hr Breathwork - in-person

bottom of page