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Transformational Hypnosis Therapy
CLIENT NOTES:
Your content has been submitted
CLIENT INFORMATION
PREFERRED NAME:
Sydney
DATE OF BIRTH:
May 6, 2025
PHONE NUMBER:
4248324000
ADDRESS:
EMERGENCY CONTACT NAME & NUMBER:
Thomas Murray
3108697775
RELATIONSHIP STATUS:
Husband
OCCUPATION:
Costume Design & Production
How did you hear about us?
Online search for hypnosis in my area
HEALTH INFORMATION
Are you being treated or have you ever been treated for any psychiatric illness? If yes, please explain briefly.
no
Have you ever seen a counselor, psychotherapist, or psychologist for any issue? If yes, please explain.
therapist for divorce and personal growth 1998
Are you currently taking any prescribed medication? If yes, please list.
no
Have you experienced any traumatic life events that I should be aware of? If yes, please explain.
no
ADDICTIONS:
None or N/A
ANXIETY
Stress
EATING PROBLEMS
Exercise
DEPRESSION
None or N/A
CAREER ISSUES
None or N/A
CONCEPTION PROBLEMS
None or N/A
PAIN CONTROL
RELATIONSHIPS
None or N/A
DIABETES
None or N/A
Have you ever had serious thoughts of harming yourself or others?
no
Do you or any member of your family have a history of epilepsy?
no
Have you ever been hypnotized before?
no
What areas of your life would you like to work on?
motivation to pursue personal creative projects- finding work/life balance
What is the biggest challenge that you wish to work on during your session?
Re-imagine self as artist that I was before allowing corporate entertainment career to take over my focus and time.
Have you tried to do anything about this before now? If so, what?
Yes. I stepped away from corporate entertainment and pursued teaching a opportunity which was very fulfilling until Covid interrupted and changed the demands and experience. We made a choice to move closer to aging family members to support and be available. Now I am finding new balance with a comfortable, yet lower profile job with less compensation.
EXPECTATIONS:
Find clarity on priorities and motivation to pursue personal creative endeavors/goals... possibly a transition into a consulting career.
Anything else I should know?
I have a track record of allowing the demands of my jobs (upper level management and teaching) to consume my time...in efforts to stay ahead of the business and lead others towards success at the expense of my personal time and time with husband.
Are you willing to commit to listening to your personalized recording everyday for at least 21 days?
yes absolutely
Are you 18 years of age or older?
Yes
AGREE TO TERMS:
I agree to all of the terms and conditions listed above.
WEIGHT CLIENTS
What is your ideal weight?
When was the last time you were at or near this weight?
What is the heaviest and lightest you have ever been?
If you could design a relationship with food, what would it be like?
Can you leave food or throw it away?
Do you eat when you are bored, stressed or tired, or experiencing another emotion?
Do you use food to comfort yourself?
Do you have good and bad days?
Are your eating resolutions harder to stick to when you are out with friends?
Were you given chocolate/cakes/trigger foods when you were growing up?
Were any foods forbidden to you growing up?
Do you prefer to cook or eat out?
24-Hour Recall
Is this a typical day for you?