Buteyko Breathing Form

Fill in this form before the first meeting with your Buteyko Breathing instructor.

When we receive the form we'll get in touch with you to setup the initial appointment via Skype or telephone.

Name and Contact Info

Your Advanced Buteyko Instructor

Please fill in the name and email of your Advanced Buteyko Instructor (optional)

How should we contact you?

Please tell us how you want us to contact you. Should we use telephone, skype or email?

General Health

Chronic Diseases

Have you ever suffered from the following conditions and diseases? Do you suffer from them now? Please give full details below. For diseases you never suffered from, just leave the field empty.

Terms and Privacy Policy

Scroll down to read our privacy policy and terms

Buteyko Breathing is an individually personalized, gradual training system. Doing a Buteyko Breathing course does not qualify students to teach or guide others: It can have a negative impact if not controlled by a qualified instructor.

The Advanced Buteyko Institute does not share our users personal information with third parties. We only use it to enable users to login to the app and help our instructors give students personalized instruction, advice and support.

Students should always consult their doctor before engaging in Buteyko Breathing: the activities may be too strenuous or dangerous for some people.

Students signing up for a course agree not to hold drs. Eduard J.A. Reuvers, the Advanced Buteyko Institute, Advanced Buteyko instructors (as listed on the advancedbuteyko.com website) nor any other persons associated with the Advanced Buteyko Institute and website and apps accountable for any damages, liabilities, and losses that may be incurred during or resulting from courses offered by the Advanced Buteyko Institute.