Confidential Client Information

If you are new, please fill out the following Client Information Form prior to the first session as this will help save time on your appointment. If you have any questions between now and your appointment, you can contact me at any time, or we can discuss in detail at your first session.


Hypnosis is a combination of concentration and mental relaxation very similar to meditation. The best hypnotic subjects are creative, intelligent and curious. Motivation, the ability to concentrate, to use your imagination and to think positively also help you to be successful.

I understand that hypnotherapy is not a substitute for medical or psychiatric treatment. I agree to cooperate in this process and to complete any homework assigned. I have read the above statements and understand the probability of my benefitting from hypnosis.
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