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Custom Hypnosis CD form

What name or nickname are you most comfortable hearing yourself called?

Have you ever been in hypnosis before   yes no

If so, did you find the experience helpful?  first time yes no

Would you like to receive a CD in the mail or download an mp3 file CD MP3


Please answer the following questions and write as much as you would like. Please provide as many details as possible.

Please provide a description of the problem you are wanting to eliminate or goal you would like to achieve

How does the problem affect you now?

What would your life be like if this were already resolved?

What are the positive benefits you will have as a result of achieving this goal?

Anything else you’d like to  add?

After completion of this questionnaire, click “SUBMIT” and you will be taken to a different page where you can provide your address and payment information.The payments are processed on a secure server. Thank you for ordering and have a great day!


*I guarantee it for as long as I am in the business.

Disclaimer: The statements contained on these pages have not been evaluated by the Food and Drug Administration. The information contained here is not intended to diagnose, treat, cure, or prevent any disease. Suggestions and ideas presented in this document are for information only and should not be interpreted as medical advice, meant for diagnosing illness, or for prescriptive purposes. Readers are encouraged to consult their health care provider before beginning any cleanse, diet, detoxification program, or any supplement regimen. The information in this document is not to be used to replace the services or instructions of a physician or qualified health care practitioner.