Indiana Integrative Hypnosis
  • About IIH
    • Testimonials
  • What is Hypnosis?
    • Virtual Sessions
    • Coping with Stress & Anxiety
    • FAQ's
  • Specialties
    • Weight Loss Hypnosis
    • Faster EFT (Tapping)
    • Corporate Stress Management
    • Childbirth Hypnosis
    • Other Goals
  • Resources and Tools
    • Forms
    • Cancellation Policy
  • Online Sessions
  • Contact

INTAKE FORM



    What do you want to accomplish with integrative hypnosis today?

    ​What is your prior experience with hypnosis?

    What are your beliefs about hypnosis?

    ​What are your three biggest personal strengths?


    HEALTH: List all medical &​ mental health conditions for which you are currently being treated.

    Fill out if you are here for Weight Release:
    Fill out if you are here for Smoking Cessation:


    Please check all that apply:


Submit

Hypnosis Intake Form
File Size: 20 kb
File Type: docx
Download File


**Cancelation Policy**

ANY CHANGES IN APPOINTMENT TIME OR CANCELLATIONS NEED TO BE MADE AT LEAST 24 HOURS PRIOR TO SCHEDULED APPOINTMENT OR THAT SESSION IS FORFEITED. THIS IS STRICTLY ENFORCED.

SCHEDULE A FREE 15-MIN PHONE CONSULTATION TODAY

Fill out this short form and we'll get in touch to schedule your free consultation.
Get Started
Serving Carmel, Fishers, Zionsville and the Greater Indianapolis Area

Contact Us

1081 3rd Ave. S.W.
Carmel, In 46032
317-706-0306

cathy@indianaintegrativehypnosis.com

Website by Tech Lift X
  • About IIH
    • Testimonials
  • What is Hypnosis?
    • Virtual Sessions
    • Coping with Stress & Anxiety
    • FAQ's
  • Specialties
    • Weight Loss Hypnosis
    • Faster EFT (Tapping)
    • Corporate Stress Management
    • Childbirth Hypnosis
    • Other Goals
  • Resources and Tools
    • Forms
    • Cancellation Policy
  • Online Sessions
  • Contact