Somatic Singing
Client Intake Form

Your Music & Healing Journey

Please fill out the form below before your first session or class so that we may better cater the experience to you and your needs.
Part 1: Experience

Let us know about your experience with your voice, both in singing and in life.
Part 2: Health

Let us know about your health so that we can help you on your healing journey.
Part 3: Energy

Let us know about your personality & energy so we can customize your care.

Part 1 takes approximately 2 minutes to complete.
Feel free to hit "play" on the music below to accompany your form-filling self-care and reflection time! 
(This song is 2:12 minutes long.)
CLIENT INTAKE FORM

Part 1: My Experience
Name Email Preferred pronouns How did you hear about Somatic Singing? What is your comfort level with singing? How often do you meditate? Are you familiar with yoga breathwork?
Are you familiar with any of the following? (check all that apply)
Accupressure
Ayurveda
Breathwork
Breath Anatomy & Physiology
Body Talk
Chakras
Energy work
Fascia
Gymnastique Sensorielle
Guided Meditation
Gut Biome
Gut-Brain Axis (GBA)
Iyengar Yoga
Nervous System Physiology
Pranayama
Polarity work
Reiki
Somatic Therapy
Speech Level Singing
Traditional Chinese Medicine (TCM)
Vocal Warmups
Submit

Part 2 takes approximately 2 minutes to complete.
Feel free to hit "play" on the music below to accompany your form-filling self-care and reflection time! 
(This song is 2:06 minutes long.)
CLIENT INTAKE FORM

Part 2: My Health

Please let us know if you've experienced any of the following health conditions, as they can store energy in the throat, lungs, and gut, which all affect the voice.
Name Preferred pronouns
Relevant Health Issues (check all that apply)
Anxiety (social or otherwise)
Arthritis (neck or shoulders)
Asthma or Respiratory issues
Autoimune diseases
Autism spectrum
Bipolar disorder
Cancer (thyroid or lung)
Cancer (other)
Chest pain
Constipation, IBS, or Abdominal pain
Covid-19 (lasting cough)
Covid-19 (no lasting symptoms)
Cystic Fibrosis
Deafness
Depression
Diphtheria
Easting disorders (Anorexia or Bulimia)
Gastroenteritis or frequent vomiting
Gastroesophageal Reflux (acid reflux)
Gut issues or bloating
Heart Conditions
HIV or AIDS
High Blood Pressure
Hyper/Hypothyroidism
Laryngeal Papillomatosis
Nerve disorders
Multiple Sclerosis
Pain (neck, shoulders, jaw)
Parkinson's disease
Scoliosis
Tuberculosis
Whooping Cough
other
Health issues not listed: What I'm feeling and healing Submit

Part 3 takes approximately 2 minutes to complete.
Feel free to hit "play" on the music below to accompany your form-filling self-care and reflection time! 
(This song is 2:05 minutes long.)
CLIENT INTAKE FORM

Part 3: My Energy
Name
Chakras I'm interested in working with:
🔴 Root
🟠 Sacral
🟡 Solar-Plexus
🟢 Heart
💠 Throat
🔵 Third-Eye
🟣 Crown
all of the above 🌈
not sure yet 💭
What is your Ayurvedic Dosha? What is your TCM Temperature? What is your TCM Element? What is your Astrological Sun Sign? (optional) Submit
CLIENT INTAKE FORM

Voice Blocks
Name What are some physical blocks you experience in the voice? What are some mental blocks you experience in the voice? What are some emotional blocks you experience in the voice? What are some energetic or spiritual blocks? “Soul blocks”? Submit

About Somatic Singing Sessions
Feel free to hit "play" on the music below to accompany your form-filling self-care and reflection time! (This song is 4:05 minutes long.)

SOMATIC SINGING

About Somatic Singing Sessions

In these sessions, we use guided meditation, yoga breathing exercises, vocal warmups and singing to help:
  • clear the mind
  • calm the vagus nerve
  • tap into the emotional body
  • release emotional blocks around singing or speaking
When in a deep state of meditation, oxygenated breath, and voice expression, we can also switch our nervous system from the sympathetic fight-or-flight mode to the parasympathetic stay-and-ground mode. This state of mind is a space where deep healing can take place. It does take quite a bit of time to get to this place. Keep that in mind as you book your sessions ~ a few longer sessions will yield more results than several shorter sessions.

The first session is more conversational with some light meditation, beginner breathing exercises, quiet vocal warmups, and light energy work if there's time. 
We recommend finding a quiet space where you can hear well. Oftentimes people feel a little self-conscious while singing in front of a coach for the first time. That's totally normal (and exactly what we're here to work on!) But if you're feeling particularly introverted on a session day, we can always do more energy work around healing mental voice blocks, and save the actual singing for later sessions.
These sessions are very customizable to fit your needs and environment. 
After your first session, your vocal wellness coach will develop a custom voice routine for you and some singing exercises you can do together for next session.

Questions? Comments?
Feel free to hit "play" on the music below to accompany your form-filling time!
CLIENT INTAKE FORM

Questions? Comments?
Name Email Questions? Comments Submit