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Rate Your Breathing

Do you:

Get a blocked or runny nose?
Yes
No

Get frequent colds, flu?
Yes
No

Get asthma or breathlessness?
Yes
No

Get allergic rhinitis (hay fever)?
Yes
No

Get breathless during sport or exertion?
Yes
No

Snore?
Yes
No

Suffer from sleep apnea or insomnia?
Yes
No

Make nightly trips to the bathroom?
Yes
No

Get stressed easily or suffer from panic attacks?
Yes
No

Frequently feel tired and fatigued?
Yes
No

Suffer from frequent headaches/migraine headaches?
Yes
No

Miss days at school/work because of your condition?
Yes
No

If you answered yes to any of these symptoms, a Buteyko course will benefit you. 

Fill out the form below and send it to us if you would like more information (on a no-obligation basis).  We will send you a copy of our more-comprehensive breathing assessment on request.

Name

Phone

Email

Comments

Helping people with breathing disorders since 2001

20 Arthur Street, Freemans Bay, Auckland 1011, New Zealand  |  Phone +64 9 360 6291  |  Email info@buteykobreathing.nz

Download our leaflets [PDFs]:  Do you suffer from asthma or allergies? »    Do you snore or suffer from sleep apnoea? »

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Registered Practitioner / Practitioner Trainer
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