Private Hypnotherapy Inquiry & Application
Please read this full description :)

This form is for anyone curious about whether hypnotherapy will support you in your goals for growth and healing OR you are a woman preparing for childbirth and want to train your mind to achieve a safe, healthy, blissful birth - without fear or even pain. With the power of your subconscious mind, the possibilities of what you get to believe, who you get to be, and the life you get to create are endless. 

Hypnotherapy is an incredibly safe and effective process to rewire your brain. Despite common misconception, it is not a process that is done to you and through which you lose control, but rather it is a done with you process that amplifies the availability and accessibility of your truest, most authentic power. 

To get the MOST success from your sessions, be fully committed to showing up to sessions, practicing given "homeplay", and nurturing open and honest communication with your hypnotherapist.

Are you ready to commit to the work and achieve your goals?

I can't wait to work with you! 

HERE'S HOW IT WORKS
1. Fill out the form below. Be THOROUGH and DETAILED in your responses.
2. If we are aligned to work together and/or if further clarification is needed, we will schedule a free 20min consult call to prepare for your first session.
3. Sessions are typically 90min-2hr in length and are held over Zoom (join from anywhere!).
4. You will be provided with "homeplay" resources to further integrate your therapeutic process including but not limited to hypnosis recordings, journaling, breathwork, and/or embodiment practices. 
5. Book 1 session for $108 or 3 sessions for $225 ($75 each)
6. Payments can be made via Venmo, Paypal, or Zelle and must be completed 

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Email *
First Name:
Last Name: *
Location and timezone: *
Age: *
Gender: *
Please describe your interest in hypnotherapy. What are you hoping to address with hypnotherapy and what would you like to achieve? *
Approx. how long has this been present? *
If your presenting issue includes weightloss, how much weight do you desire to loose? *
Are you currently taking any prescription medications? (this is important to know as some medications can present contraindications to hypnosis). Write N/A if this does not apply to you. *
Are you currently or have you ever worked with a medical doctor, therapist, psychiatrist or other type of practitioner to address this specific concern? Please describe. Write N/A if none. *
Do you have any questions regarding hypnotherapy or is there anything else you want me to know before our consult? Write N/A if none. *
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