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Complete this form, including your reason for seeking hypnotherapy.
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• ”I’ve had insomnia over a decade, but lately it’s spiraled to the point where I’m barely functioning. This has got to change.”

• “My daughter seems anxious all the time about school. We’re looking for extra support to help her cope.”

• “I’ve been having migraines since I hit puberty and now I’ve maxed out on my medications to the point I’m rationing them. It’s freaking me out, I need to find another way.”

• “I’m getting married this fall, and I really need to get rid my fear of flying so I can enjoy my honeymoon.”

• “I have a major exam coming up in a few months, and the stress has made it almost impossible for me to concentrate. It’s like my mind is going in a million different directions.”

• “I’ve been divorced for about two years now, and instead of moving forward, I still feel angry and resentful.”