Rossell Fitness Mindset Questionnaire

All boxes/questions must be answered for the form to be valid for submission.

If you are uncomfortable answering any question in particular, please put an X in the box.

Be as honest and open as you can, this will not be shared with anyone else and will be used to strengthen results we can achieve together!

  • We will use your email to send you some follow up information related to the answers in your questionnaire. By filling this form in and submitting the form to us you are giving us your consent to contact you via email.
    Breathwork has amazing benefits for calming down your nervous system and can be great at helping with the management of stress, anxiety and gut issues.
  • If this is not applicable to you please type N/AIf you would prefer not to say please type PREFER NOT TO SAY
  • for example anti-anxiety meds, antidepressantsIf you would prefer not to say please type PREFER NOT TO SAY
  • If you do not want to share anything here, please type X into the box