This page is a prelude to the construction of an E-course to be linked to an e-commerce facility. Look out for an announcement in the near future.

e-Hypno-Counselling Form

Please enter your membership details to arrange for an e-hypno-counselling session:-

Enter Name

Enter Email

Please state your problem in the given text area box provided and fill in the following questionnaire necessary for hypno-analysis.

Enter an account of your health disorder for Hypno-Counselling:

Please answer the following questions to enable us to access and analyse your level of knowledge on hypnosis and ability to relax in order to extend a more precision-based e-hypno-counselling and e-hypnotherapy session. Start off with an example set by the first question with a default answer.

1. What is your favourite alternative therapy for now?

Hypnotherapy
Psychotherapy
Homeopathy
Kinesiology
Neuro Linguistic Programming

2. How much do you think you know about hypnosis?

Not at all
I read a little bit
I read alot about it
I took courses before
I practice self-hypnosis

3. Have you been hypnotised by a hypnotherapist before?

No
Yes, once or twice
5-10 times
Multiple therapy sessions
I took part in stage hypnosis show

4. If you had been hypnotised before, have you benefitted from hypnosis? If so, state how it came about and the outcome, otherwise just type in the box "No".

Enter an account of your experience with hypnosis:

5. To which of the following psychosomatic problems would you think are best addressed by hypnotherapy? You can tick more than one box.

Phobias
Broken leg
Bad Habits (include: smoking, drinking, procrastination, etc)
Cancer
Insomnia
Depression
Diseases (medical condition)

6. Choose your preference for learning about hypnosis from the menu: