A FEW QUESTIONS BEFORE WE GET STARTED

To help me prepare for our session and use our time as efficiently as possible, please fill in the form below. Once I receive the form submission, I’ll send you an email with suggested dates and times. Please be aware the expected call duration is 90mins but I allow for an extra 15 for greetings, goodbyes and any extra chat. Please set aside this amount of time in a quiet space where you won’t be disturbed. Look forward to speaking to you soon!

Name

First Name

Last Name

Email Address

What would you like to achieve through the Wim Hof Method?

Improved immune function? Greater cardiovascular fitness? Learning to manage stress more effectively?

Do you currently have( or in the past suffered) any long term health conditions?

Either physical or psychological, and please indicate the timespan that you have dealt with the condition(s).

Are you currently taking any prescribed medications?

If so, please make clear which conditions the drugs have been prescribed for and dosage.

What is your profession and how much time does it take from each day?

Include time taken travelling to and from work, plus any work you might do at home.

Please choose the option you feel best describes your relationship with meditation:

If you unsure, please be modest in your response.

What days/times are generally good to arrange a call?

Weekdays/weekends, mornings/afternoons/evenings - I can be flexible to suit your schedule.

Anything else you'd like to add before we start?

Please include any useful information not covered above.

I hereby declare to have filled in this form truthfully:

Yes

While you're waiting for a reply, why not check out some free health tips and read about other success stories in my journal?

Breathwork Questionnaire

A FEW QUESTIONS BEFORE WE GET STARTED