Sensorium Hypnosis

Are you currently working with an alternative medicine practitioner, such as an acupuncturist, massage therapist, naturopath, chiropractor or energy healer?

Yes
No

Do you work in the healing arts industry?

Yes
No

Have you attended a yoga or meditation class within the last 30 days?

Yes
No

In your lifetime, have you successfully overcome an addiction to alcohol, drugs, gambling and/or food etc.?

Yes
No

Are you currently working with a talk therapist?

Yes
No

Are you currently enrolled in any classes or pursuing a certification or degree?

Yes
No

Do you exercise 3 or more times per week?

Yes
No

Please help me get to know you better by answering a few quick questions: