Client Forms

Each of the assessments below have a very specific use in contributing to the work we will do together in session.  Your therapist will inform you of which particular assessments you will need to do and when.  Providing your therapist with this information outside of your appointment saves valuable time and cost to you and also creates a more effective session.

When filling out a form, we ask that you read the instructions for each one carefully and be certain that you press the “Click to send” button before leaving the page, so as not to have to do it again.

Personal Information

Please fill out the following form as completely as possible. By completing this online we will save several minutes of your first session. Your personal information is confidential and remains the property of Timeless Hypnotherapy.  

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Communication Questionnaire

By undertaking the following questionnaire before your first session, you help your therapist to hear you better and understand the meaning in your words through the preferred communication style that you use. It is important to know that this is not a test, there are no wrong answers – the information we gather simply aids your …

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Presenting Issue Assessment

The Presenting Issue Assessment is designed to assist you in clarifying and understanding the area/s of your life you want to look at in therapy and the goals you are working towards. By answering the questions, you begin the journey of healing and growth and you give your therapist a deeper sense of how to conduct …

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The Checklist of Life Experiences

Following is a checklist of experiences and interests that many people have had. By rating the experiences it will help us better understand and appreciate you as an individual. In the space next to each item which you have experienced, please rate experience on a sliding scale from 1 to 5. Use the number 5 to rate the …

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Referral Forms

Referral forms can be emailed to Pain Management Referral Form Weight Reduction Referral Form Smoking Cessation Referral Form

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