Let’s work together.Please complete your Intake Form before your first session. Name * First Name Last Name Email * Phone * (###) ### #### Reason for session? * Have you ever worked with a hypnotherapist? * Yes No If yes, what was your experience like? benefits? dislikes? * How long has this been an issue? * How is this affecting your life? * Please share any relevant background information here: * What is your spiritual belief? * Do you have Epilepsy? * Yes No I understand that the program of conditioning offered by you will include an undetermined number of private session, depending on my individual needs. I understand and agree that the major purpose of this program is for Vocational or Avocational self-improvement and that problems or psychogenic or functional origin are treated by psychological or medical referrals only (Business and Professional Code 2908) I also understand that there are no guarantees as to the results or progress to be made, only that you will, to the best of your ability, endeavor to accomplish the objective of my sessions. Missed Sessions/Cancellations/Rescheduling. If you need to reschedule a reserved Coaching session, you must do so at least 24 hours in advance of your scheduled session in order to credit your session fee toward a new session. If you reschedule a Coaching session with less than 24 hours-notice, then your original session fee will be forfeited and a new session fee will be due to reserve a new time. More Love More Magic reserves the right to reschedule Coaching sessions giving you a 24 hour notice before your session, and will coordinate a new time with you. If you are really ready to make a commitment to change, consider my package discounts to help you save money and book more sessions! Prices are subject to change at any time. Full Name (As Signature) * I have read and agreed to the terms above * Yes Thank you!
