There are 3 documents to fill out, review and / or sign.  Please do your best to complete these the day before your appointment. 

1) Questionnaire-

Select ONE 

General Behaviors

Alcohol/Drug Dependency

Smoking Cessation/Stop Dipping/Stop Vaping

Weight Management

ED Intake Form– Sexual Performance

2) Your Suggestibility Evaluation

‘Suggestibility’ is how you take in information, it is about communication, hypnosis is simply communication.   Return via scan, send me your score or bring with you the day of your appointment.  Please download here: Suggestibility Questionnaire 

3) Disclosure and Engagement Document

Please read and sign our disclosure and engagement document, at this link disclosure and engagement0124 Return via scan, or bring with you the day of your appointment.  We also have copies here in the office if you don’t have access to a printer.

A Client’s Words:
Thank you for the wonderful session. I was still floating in the Light when I left.

It meant so much to me to totally disconnect from the conscious world and find my secret garden. The first time we met (10 years ago), you made a great impact on my life. 

Joy – Addison

3 thoughts on “New Clients”
  1. I have been interested in finding a good hypnotherapist, for many years. After watching Valerie’s “Duck” video, I realized this is an excellent center for me to get help through. Very enlightening. I am excited about my first session.

  2. I am interested in hypnotheray. I have issues with socializing, and how much do you charge

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