Get Nlp Hypnotherapy Intake Form

Completing the Nlp Hypnotherapy Intake Form online is an essential step towards receiving effective hypnotherapy and NLP services. This guide provides clear and supportive instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the intake form with ease.

1. Press the 'Get Form' button to download the intake form and open it in your preferred online editor.
2. Fill in your name in the designated field at the top of the form.
3. Enter the date on which you are filling out the form.
4. Provide your address in the specified sections. Ensure your details are accurate and complete.
5. Input your home phone and cell phone numbers in the respective fields.
6. Indicate whether it is acceptable to leave messages at your given phone number.
7. List your email address clearly for further communication.
8. Enter your date of birth to assist in identifying your background.
9. Specify your occupation to provide context for your assessment.
10. Select your marital status, ensuring to give an answer that resonates with your situation.
11. Indicate if you are right-handed or left-handed to aid in personalized assessment.
12. Identify your educational level to give insight into your background.
13. Describe the main issue you wish to address through NLP and hypnotherapy in the outlined section.
14. Report any medical conditions or challenges that could impact your therapy.
15. State whether you are currently under a physician's care for any mentioned conditions and include your physician's name if applicable.
16. Mention the date of your last visit to your physician to provide relevant medical history.
17. If you have experienced hypnosis before, explain your experience briefly.
18. Provide any history of mental health treatment and summarize its outcomes.
19. Reflect on what you value in life in the appropriate section.
20. Consider and articulate what you believe is hindering your success regarding your challenges.
21. Indicate if you have encountered NLP or hypnotherapy before and provide a description of that experience.
22. Specify how you learned about Suzy Grossman to assist in understanding your referral source.
23. Outline any additional issues you would like to resolve, selecting from the options provided.
24. Review your entries for accuracy and completeness.
25. Finally, save your changes. You may choose to download, print, or share the completed form as needed.

Take the first step towards positive change by completing your intake form online now.