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FlowFactr Intake & Breathing Evaluation Form

Before we meet for your free consult, we ask you to complete this quick intake and a couple of science-backed evaluations.

Why?
Because we don’t guess — we measure.

These evaluations uncover what’s really happening with your sleep, breathing, and energy so we can skip the small talk and get straight to helping you feel better.

👉 Here’s what you’ll do today (takes about 10–12 minutes):

* A short intake snapshot (just the basics)
* A quick medical check-in (for safety)
* The Nijmegen Questionnaire (20 questions on breathing health)
* The Self-Assessment (20 questions on sleep + performance signs)
* The BOLT Test (a simple breath-hold score you can do at home)
No stress — this isn’t a test you “pass” or “fail.” It’s a starting point.
The answers guide our consult so you get a clear, personalized path forward.

💡 Pro tip: Be honest and don’t overthink. The more real your answers, the faster we can uncover what’s holding you back.