Hypnosis Session Application Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *1. What would you like to work on during our 1 hour hypnosis session? Some common themes are confidence, self love, self worth, love & relationships, money, career etc.. Please only choose one theme to get the best results!2. What are the challenges in your current life in relation to this specific area? What specifically would you like to improve?3. How is that currently a problem for you?4. How does the best possible outcome look like, feel like for you?5. What is important to you about this outcome?6. What would you gain if the problem was solved?7. What would you lose if the problem was solved?8. Have you experienced hypnosis before?9. Do you have any phobias or triggers that I should be aware of? (For example, I sometimes use visualisation of being in an elevator or scuba diving as deepening techniques)10. Have you ever received a mental health diagnosis from a professional? If yes, please list everything here. (This is for your own safety as hypnosis is not recommended with certain diagnosis)11. Do you understand that, according to the Law, all hypnosis is self hypnosis?Submit ** All of the information provided in this form will remain strictly confidential.