Application for Transformational Hypnotherapy with Sally Guthrie
Date & Time Preference *
Please list preferred times & your availability so we can do our best to offer you a convenient time.
Clinic or Online Session *
All sessions can be booked either for face to face or online for your convenience. Online sessions are equally as effective as face to face. Please note Clinic Sessions are in Sydney Australia.
Time Zone if booking Online Session
Please list the town, state & country you'll be in for your online session... to ensure scheduling accuracy
Date of birth *
Date of birth *
If in Austrailia only
Please briefly describe your ONE main concern - the reason for your session *
ie If I had a magic wand what is the ONE thing you want freedom from?
What is your desired result/outcome of our session? *
Marital Status *
Doctor's name, address & date of last check up
Please list all medications & supplements being taken *
If your issue is a physical illness or problem. Please explain & list your symptoms, doctors recommendations/prognosis & any info you feel relevant...
Please select the areas that currently concern you from the list below: *
Please add anything you feel is relevant in relation to the selections you've made or issues you struggle with... (even if not listed)
Have you had hypnosis before: *
If yes, what for & how helpful was it?
How did you hear about Sally? If referred pls let me know by whom... *
POST SESSION COMMITTMENT *
I understand the importance of listening to my personalised recording daily, for at least 3 weeks to ensure optimum results
I commit to listening to my recording.
CANCELLATION TERMS *
All booked appointments require a nonrefundable $90 deposit. Any cancelations made with less than 48hrs notice are charged in full. These terms are created to ensure we value each other's precious time.
I agree to the above cancellation terms
Payment details will be forwarded on confirmation of your successful application. Sessions are $490AUD Price includes your 90min-2hr personalised session, your personal recording & a 30min follow up/review consult 3-4 weeks later & of course your new freedom.
If money is a barrier please request payment options here.