This page has all the information and an easy on-line intake form (optional) that you may complete before you arrive for your appointment.
First let's make an appointment:
Professional Courtesy and Client Safeguarding
1. If you have been diagnosed with any of the following conditions, I must have a doctor’s written permission to proceed with your hypnosis session:
____Schizophrenia ____Chronic Depression ____Bi-polar ____
Heart Disease ____Epilepsy
2. If you are already seeing a health or wellness professional for assistance with the goal for which you are seeking hypnosis, as a matter of courtesy and to enhance your care, please advise them of your intention to undergo hypnosis; and bring a note from them advising me that they are aware of your intention and that to the best of their knowledge there is no reason why you should not be hypnotized.
For your convenience, you may use the following form:
If neither 1. or 2. apply to you, you are ready to proceed to the next step.
Optional On-Line Process
You may help me automate this process by filling this out on-line right here before your first appointment. This is a secure website and I keep my computer secured with a password and of course my files locked. However, I cannot guarantee that this website will not be hacked or that someone at Vistaprint may get access to your information. So, if you prefer to provide some or all of this information in the office or via email before your visit, I absolutely understand your concern. Or, you may download the form here and bring it with you:
If you would prefer to do it now, please provide as much information below as you are comfortable sharing on-line, knowing that even though I expect it to remain confidential I cannot promise that no one else may see it besides me.
We will go over it in the office so you can provide further details then.
Thanks so much.
Thank You for scrolling so far and sending me information about you! I value your time and trust.
Looking forward to seeing YOU soon!