Please call (603) 749-6463 to schedule your free hypnosis screening. Regardless of which issue you wish to address (smoking cessation, weight loss, sleep issues, etc.), we ask that you fill out some forms for the registration process. Please click below and download the appropriate forms and bring them to your first session:

• Client Intake Form
• Client Bill of Rights
• Questionnaire specific to your issue, if one is listed. See "Issues Addressed".
• A written referral must be submitted from your physician for any medically diagnosed condition PRIOR to your first session.
  Referral Form

ALL FIRST TIME CLIENTS ARE REQUIRED TO LISTEN TO A 24-MINUTE "ORIENTATION" AUDIO PRIOR TO THEIR FIRST APPOINTMENT. The information on this Audio will answer your questions on what Hypnosis is and isn't and will greatly increase your success. This can be accomplished in several different ways:

1. Click here and listen on your computer.
2. Arrive an additional 30 minutes prior to your scheduled appointment time and listen in our office.
3. Stop by either the Dover or Hampton location during normal business hours and pick up a free CD.

If you are unable to download and complete the forms in advance, please plan on arriving 10-15 minutes early to complete paperwork. Listening to the "Orientation" CD will require an additional 25 minutes.

Below is a listing for each issue that we address and the appropriate forms you will need to have completed upon your first visit.

Smoking Cessation

• Tips to Becoming a Non-Smoker
• Our Guarantee Contract
• Becoming a Non-Smoker Questionnaire
• Client Intake Form
• Client Bill of Rights

Weight Loss

• Reaching My Ideal Weight Questionnaire
• Client Intake Form
• Client Bill of Rights

Erectile Dysfunction

• ED Questionnaire
• Referral Form
• Client Intake Form
• Client Bill of Rights

Sleep Issues

• Sleep Issue Questionnaire
• Relaxation Tips
• Referral Form
• Client Intake Form
• Client Bill of Rights

Stress Management

• Relaxation Tips
• Client Intake Form
• Client Bill of Rights

Pain Management

• Pa_n/Discomfort Questionnaire
• Referral Form
• Client Intake Form
• Client Bill of Rights