Foundations Questionnaire

About Private Sessions Resources Blog Contact Programs

Foundations Facilitator Training Questionnaire

Restorative Breathwork® Foundations

Name

How did you hear about Kathleen Barratt and Restorative Breathwork?

Are you taking this program to deepen a personal practice or to advance professional skills or both?

Do you have previous experience with other systems of breathwork? If so, please describe the style of practice(s) or areas of study. Examples include styles (e.g., pranayama, Holotropic Breathwork™), receiving breathwork from a facilitator, and theoretical (non-experiential) studies.

Please list any professional training and certificates or degrees you have in the fields of mind body wellness.

Do you have any chronic pain, physical limitations, or disabilities? If yes, briefly describe.

Have you had a serious illness or major surgery within the last five years? If yes, briefly describe.

Do you currently have or have you had any of the following conditions in your lifetime?

Respiratory conditions

Heart disease or other cardiovascular problem

High Blood Pressure

Seizures or strokes

Hypertension

Detached Retina

Glaucoma

Epilepsy

Diabetes

Diagnosed mental-health conditions

Anxiety or panic attacks

Severe migraine headaches

Home

Restorative Breathwork Programs

Restorative Breathwork Foundations

Restorative Breathwork Facilitator Certificate Training

Private Mentoring with Kathleen Barratt