Emily Catford Therapies - Enquiry Form - NLP, Timeline Therapy™ & Hypnotherapy

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Please fill out the following form and I will get back to with more information.

For Information...

Hypnotherapy Recordings will be sent via your email address for you to listen in your own time.

Coaching sessions can either be held face to face or via Zoom, best taken as course of sessions.

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Name *

I would like to find out more about... *

A hypnotherapy recording sent to me (£95.00)

Coaching session(s) which may include a combination of NLP, TLT and Hypnosis

Email *

Phone Number *

For what issue(s) are you seeking hypnosis/NLP coaching sessions? *

Names of anyone else who is involved with your issues and to what capacity

What has caused your problem? *

Are you currently suffering from any of the following? *

inability to relax

nervousness

Insomnia/ problems sleeping

Depression

Anxiety

Compulsions

Nightmares/bad dreams

Childhood Trauma

Poor self-esteem

Cigarette smoking

Drug abuse

Alcohol abuse

Over eating

Serious eating disorder

Poor health

Lack of focus

Abuse

Relationship Issues

Current Illness

Trauma

Death of a loved one

Death of a pet

Other

Obligatoire

Are you receiving any help for any of the selected above? If so, from who?

Are you receiving medications for any of the above marked yes? If so, please let me know below

Have you ever had NLP, Timeline Therapy™ or hypnotherapy before? *

Yes, for this issue

Yes, for a different issue

How do know your issue is a problem? *

What are your goals for these sessions?

Emily Catford Therapies

Psyche & Physique

info@emilycatford.co.uk

07826143611

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