The Return - Application Form

I AM SO PROUD OF YOU. CONGRATULATIONS ON TAKING YOUR FIRST STEP TOWARDS CHANGE AND YOUR HEALING AND GROWTH.

If you’re ready to start your healing journey, please fill out the application below. You will then be redirected to schedule a free call to discuss your application form and answer any questions you may have. This call is also an opportunity to confirm that we are a good fit in working with each other.

Name

First Name

Last Name

Email

How did you hear about me?

Describe in detail the main reasons you are seeking hypnotherapy.

On a scale from 1 - 10 how important is it for you to resolve this issue?

How will you know that this issue has been resolved?

Have you experienced hypnotherapy or any other forms of therapy before? Tell me about it.

Do you have any hesitations about working on yourself?

Do you have any questions?

For online sessions there are some important requirements we must meet. Please confirm you have (a) wired headset or headphones with an inbuilt microphone (not wireless), (b) a solid device with camera that captures your face and upper body with good light (laptop if preferable, phone if only option), (c) wifi that's stable for 90+ minutes?

Yes, or I will ensure I have these by our first call

No, unfortunately I won't be able to meet these requirements

The Return is my signature one on one container. And it is due to its close proximity and the deep, healing experience it offers, that it is on an application basis. As I only take a limited amount of clients, it is important that those women are serious in their commitment to themselves, open and willing to do the work and are fully invested.

I might need some more time to think about this decision

I am committed, invested and so ready for this!