Client Intake Form

Thank you for taking the time to complete this form before our first appointment.


Important Information to Assist with your Visit
*First Name
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At That’s Life Hypnosis, we do not practice medicine nor do we prescribe drugs or related treatment. Hypnotherapy is a unique and separate profession as are counseling and psychotherapy.

Hypnotherapy is not intended to be a replacement for medical care. It is offered here as a non-medical, non-chemical, non-invasive alternative to promote change, health and wellness.

Note: Those under the care of a physician should not ignore their doctor’s advice for medical problems. Consult with your physician before making any changes in his/her prescribed treatment.

That’s Life Hypnosis uses different types of hypnosis to help set specific goals, give suggestions to achieve them, and overcome personal challenges.

Under hypnosis you cannot be made to do anything that you do not truly desire to do, or anything that violates your moral or religious convictions. The success of this process depends on your participation and willingness to make changes.

There are times when one hypnotherapy session can be effective in achieving your goal. However, hypnosis is a tool and it may be unrealistic to expect lasting results in just one session. Sometimes multiple sessions may be required to achieve the desired effect.

That’s Life Hypnosis reserves the right to record sessions for our records or your benefit. All client records/materials are kept in confidence. After your session(s) please take 5 or 10 minutes to relax in our waiting area. This transitional period will be helpful to you.