Personalised hypnotherapy form for panic attacks

Personalised mp3 for panic attack order form.

Please fill in the from below to start you order for a fully tailored hypnotherapy panic attack personalised mp3 recording for building confidence. I might contact you if I feel I need more information before I record your mp3 recording if you have any objection to this please indicate so in the last box.

Panic attack personalised mp3 form

Name

Email Address

Select your age

Select type of session you would like

Your Phone number (Optional)

select your gender

Select time that you have suffered from panic attacks

Please tell me about your first memory of panic attacks

Is there any particular time when you feel that your panic attaks are worse? If yes please tell me about it.

Do you suffer from any allergies? If yes please give details.

Do you take any mind altering medication? If yes please give details

Please tell me in your own words and as much detail as possible about your panic attacks and how they make you feel. Including anything you may think is relevant no matter how silly it may sound.Message