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During a hypnotherapy session, you may revisit previous and repressed memories, featuring key people in your life to resolve an issue or gain a deeper understanding. The questions on this form are designed to help me understand who and what has shaped your life. The dates are important to clarify early life or previous memories.

This page explains a hypnotherapy session in detail, how to prepare and what to expect after. Please watch this video before completing this form.

Feeling triggered by a question?

Your emotions indicate when a particular issue in your life needs attention. Please let us know so that we can address it in person during the session. Please share honestly and don’t hold back information to ensure the best outcome for you.

Hypnotherapy Intake Form