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87428
Work with Us
Sessions
Atlanta Hypnotherapy
Stop Smoking Hypnosis
Weight Loss Hypnosis
Love Hypnosis & Relationships
Anxiety Hypnosis
Fears & Phobias
Other Issues
Store
Hypnotherapy Certification Training
About
About Sean Wheeler
About Danielle Kortava
About Arno Ma
About Aaron Morrison
About Joanna Saunders
Reviews
Media
Media
Gallery Photos
Gallery Videos
Contact Us
Search for:
20451
Work with Us
Sessions
Atlanta Hypnotherapy
Stop Smoking Hypnosis
Weight Loss Hypnosis
Love Hypnosis & Relationships
Anxiety Hypnosis
Fears & Phobias
Other Issues
Store
Hypnotherapy Certification Training
About
About Sean Wheeler
About Danielle Kortava
About Arno Ma
About Aaron Morrison
About Joanna Saunders
Reviews
Media
Media
Gallery Photos
Gallery Videos
Contact Us
Search for:
85221
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If you selected "Referral," please share the name of the person who referred you.
Have you ever been hypnotized before?
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Yes
No
I'm not sure
What would you like to accomplish? (Check all that apply)
*
Earn more money
Find your ideal mate
Heartbreak
Improve marriage/relationship
Be more productive/efficient with work
Imposter syndrome
Get in shape
Reduce anxiety
Reduce stress
Eliminate panic attacks
Eliminate fear/phobia
Help with depression
Help with PTSD
Stop worrying
Increase self-confidence
Improve focus/concentration
Stop procrastinating
Improve sleep
Become more organized
Eliminate overwhelm
Eliminate fear of failure
Stop procrastinating
Improve public speaking skills
Practice mindfulness/meditation
Tobacco cessation
Anger management
Eliminate bad habits (nail biting, skin picking, hair pulling, etc)
Is there anything else you'd like help with?
List your top three issues from above, in order of importance.
*
Why is now the right time to take action?
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How urgent is your need to find a solution?
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Not very urgent
Somewhat urgent
Incredibly urgent
How do you think your life will be better once you make these changes... personally, professionally, emotionally?
*
What other methods have you tried to resolve these problems?
*
Why haven't those methods been sufficient for you?
*
If you find a solution to your problem, are you able to invest in yourself at this time?
Yes, absolutely.
I'm not sure.
I'm on a tight budget.
On a scale of 1-10, how coachable are you?
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What hobbies or activities do you enjoy? i.e. What do you love to do?
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Do you consider yourself to be a perfectionist?
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Yes
Maybe a little
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Which of the following vacation destinations do you *NOT* enjoy? (Select all that apply)
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Beach
Mountains
Large cities
Foreign countries
I'm okay with all of the above
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Please use the area below to add any further thoughts or information you think may be helpful or relevant in any way.
95906
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