Coaching Call Intake Form

Airways Academy Coaching Session

Thank you for booking a callback to support your Airways Academy program experience. This call is designed to answer your general questions and provide clarification related to the program content or exercises. Please note: this is not a clinical consultation or treatment session.

First name

Last name

Participant's Age

What is the name of the program you are currently enrolled in?

Please share what you'd like to discuss during this callback.

Are you currently working with any other healthcare providers related to this concern (e.g., dentist, SLP, bodyworker, ENT)?

Is there anything else you'd like us to know before the call?

Acknowledgement

I understand this is not a clinical assessment or treatment. This call is for educational support only, intended to help me make the most of the Airways Academy program content. No diagnosis or treatment recommendations will be provided.

Signature of Participant (or Parent/Guardian if the Participant is under the age of majority)

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Coaching Call Intake Form

Airways Academy Coaching Session

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