Voluteer | The Breathing Nest

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Volunteer Pa!icipant Form

First Name

Last Name

Email

Age

How long have you had asthma?

Gender

Male

Female

What treatment are you on?

On the whole is your asthma:

Mild

Moderate

Severe

I acknowledge that this is an informal trial and no medical diagnosis or treatment will be recommended and that all wri"en and oral information and materials disclosed or provided is confidential

Please note that a digital metronome will be used in the recordings to help synchronise the breath. Thank you.

Thanks for submitting!

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