Client Information Form

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Please complete this form as fully as possible. The information you provide will be used to prepare for your first appointment. When you submit this form, the information will be sent directly to my email inbox and will only be seen by me. 

Any information you provide will be kept confidential in accordance with the terms of the Client Agreement, which can be viewed here.

Hypnotherapy, talking therapy and NLP are effective forms of therapy, however people respond differently and therefore results may vary from person to person. Full client commitment and participation is required. Listening to CDs / MP3s and carrying out other therapy tasks between sessions is an essential part of the process and this will be fully explained during your initial consultation.

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