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.