Please complete the form to the right to schedule your free hypnosis screening. Regardless of which issue you wish to address (smoking cessation, weight loss, sleep issues, etc.), we ask that you fill out some forms for the registration process. Please click below and download the appropriate forms and bring them to your first session:

ALL FIRST TIME CLIENTS ARE REQUIRED TO LISTEN TO A 24-MINUTE “ORIENTATION” AUDIO PRIOR TO THEIR FIRST APPOINTMENT. The information on this Audio will answer your questions on what Hypnosis is and isn’t and will greatly increase your success. This can be accomplished in several different ways:

  1. Fill out the form to listen to the “Orientation” on your computer.
  2. Arrive an additional 30 minutes prior to your scheduled appointment time and listen in our office.
  3. If you are unable to download and complete the forms in advance, please plan on arriving 10-15 minutes early to complete paperwork.
  4. Listening to the “Orientation” before your session will require an additional 25 minutes.

Below is a listing for each issue that we address and the appropriate forms you will need to have completed upon your first visit.

Weight Loss 

Reaching My Ideal Weight Questionnaire

Written Service Guarantee

Client Intake

Client Bill of Rights

Smoking Cessation

Client Intake

Client Bill of Rights

Becoming a Non-Smoker Questionnaire

Guarantee Contract

Tip to Becoming a Non-Smoker

Relaxation Tips

Erectile Dysfunction

 

Client Intake

Client Bill of Rights

Referral Form

ED Questionnaire

Sleep Issues

 

Client Intake

Client Bill of Rights

Sleep Issues Questionnaire

Relaxation Tips

Referral Form


Stress Management

Client Intake

Client Bill of Rights

Relaxation Tips

Referral Form

Pain Management

Client Intake

Client Bill of Rights

Pain Questionnaire

Referral Form