Personalised hypnotherapy form for unresolved issues.

Unresolved issues personalised mp3 order form

Please fill in the form below to start you order for a fully tailored and personalised hypnotherapy downloadable mp3. For you to release those unresolved issues and move forward. I may contact you by email if I have any questions for you before I record your session, if you have any objection to this please indicate so in the last box.

Unresolved issues personalised mp3 form

Name

Email Address

Select your age

Your Phone number (Optional)

select your gender

Select how long ago these issues go back

Please tell me about your first memory of these unresolved issues

Is there any particular time that your unresolved issues affect you most? If yes please tell me all 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 give me as much detail as possible about your unresolved issues, how it makes you feel, the affect on your life and other people. Including anything you may think is relevant. The more infomation you give me, the better.