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Private Hypnotherapy & Personal Change

Private Session Application

Thank you for your interest in working with me. Please answer the questions below so I can better understand what brings you here and whether my approach may be appropriate for what you're seeking.

Please keep your responses brief and only share what you feel comfortable sharing here. We can discuss anything else during the introductory conversation. Please do not include medical records, diagnoses, medication information, or other sensitive health or personal information in this application.

After submitting your application, you’ll be taken to my calendar, where you can schedule a complimentary 15-minute introductory conversation. I’ll review your application before we speak.

Privacy: The information you provide in this application will be used to review your request and prepare for your introductory conversation. Please see the Privacy Policy for information about how your information is collected, used, and handled.

How long has this been something you would like to change?
Less than 6 months
6-12 months
1-3 years
More than 3 years
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