If the patient is under 18 years of age, enter guardian information below.

What to Expect in your Transform Now Hypnosis Coaching Sessions:

The hypnosis coaching process takes from 50-70 minutes, approximately. It depends on the individual. It requires guiding you to a relaxed, comfortable place within yourself, using a series of relaxing breathing & visualization techniques, starting with what is known as “induction” and then various “deepeners” moving you directly into the subconscious mind where you are given hypnotic suggestions to help you to achieve your goals; you are fully aware and in control of your session at all times.

I hereby authorize Vanessa Wawrzynowicz, CHT, Hypnosis Coach, to hypnotize me for the purposes outlined in this intake form. I understand that the success of my hypnosis coaching sessions depends greatly on my own ability to relax and desire to create change in myself. I understand that because the results of my sessions depend in part upon my own serious participation, that Vanessa Wawrzynowicz CHT, Hypnosis Coach, cannot offer any guarantee of the success of my treatment. I am aware however, that Vanessa Wawrzynowicz CHT will do everything reasonably in her power to ensure my success. Client acknowledges understanding this questionnaire, and all information provided is accurate and complete to the best of the client’s knowledge and that hypnosis coaching is a healing modality working alongside, not instead of therapeutic and/or medical care.