Health History Form

  • Below is the form I use for intake of new students; before your first lesson, I would love for you to fill it out for me. I realize this form is extensive, and some of the questions are outside the scope of traditional voice training. My approach to training looks at your entire body as supportive of your singing, so I like to have as much information as possible about your story and what you've been through as a human being. Anything written here is 100% confidential; that being said, any questions that you don't want to answer, you can leave them blank, no questions asked.
  • Vocal Health History

    Have you experienced/do you experience any of the following?
  • Are any of the following part of your vocal history?

  • General Health History:

    (please include anything that you are comfortable sharing, even if it doesn’t seem relevant to your voice. If you broke your big toe, I’d like to know about it.)
  • Breathing Questions

    The terms below relate to your breathing habits; rate yourself based on how often you experience these things.
  • Insula/Vagus Nerve Questions:

    Your vagus nerve controls all vocal functions, as well as a large portion of your breathing habits. It also communicates directly with a part of your brain called the insula; the insula is responsible for how you feel in your body, and is a big player in controlling performance anxiety. The questions below give me an idea if this is an area we should explore together. If there's any question that you don't feel comfortable answering, you can leave it blank.
  • Other Health Information:

  • This field is for validation purposes and should be left unchanged.