CLIENT INTAKE FORM
Introduction to Integrative Medical Hypnotherapy
Instant Subconscious Reprogramming
MBBR makes Change Easy, Successful, and Permanent
Using MBBR, Mind Body Behavioral Reprogramming, and Custom Designed Protocols, we will clear up confusion, fears, anxieties, inconsistencies, anger, identity, and boundary issues. Ending victimhood, unworthiness, stress, addictions, PTSD, pain, and Repetitive Life Patterns is easy using Integrative Medical Hypnotherapy.
Behavior modification results automatically once core issues have been deleted and the rescripted program has been substituted for the removed material. One Session Instant Subconscious Reprogramming takes place instantly by erasing and replacing the beliefs, programs, conditioning, behaviors, emotions, memories, and traumas that are sabotaging your life.
Bringing your subconscious mind into alignment with your conscious mind goals is the aim of this whole person mind body spirit approach. When you bring your dual mind into congruence, your goals and aspirations manifest automatically. By deleting subliminal programs which are not your own and replacing them with your positive life supporting ones, you can order anything you want from the universe because you will be in harmony with universal energy as a co-creator.
Please answer these questions as honestly and completely as you can. I will be using this Intake Form as a guide during your sessions to assist you in releasing programming that is blocking your healing, success, relationships, finances, happiness, health, and goal achievement.
Answer with the first thing that comes to mind without thinking about or analyzing your answer. Many hidden family messages, covert implications, and even overt messages are still automatically triggering from the subconscious mind and are at the root of Repetitive Reactions, Behaviors and Life Patterns. Intact intergenerational programming is often self sabotaging and demeaning. This is your opportunity to clean up any old hurts, esteem issues, traumas, and negative conditioning so that you can enjoy healthy interpersonal relationships.
MBBR is a non-intrusive, non-imprinting, non-traumatic respectful process that leaves everyone feeling secure about themselves and their ability to handle life situations. The process creates a tighter bond between you and those close to you as a result of your coming to know and understand yourself and better appreciate your gifts and talents. Loving and respecting yourself, you have love and respect to give to others. Everyone wins.
We will be accessing the subconscious mind, which is the auto pilot of your life. The intergenerational and mass conscious beliefs, programs, erroneous conclusions, personal vows and left over residues held in this dominant part of the mind, are creating and attracting the events, people, and body conditions you experience as your life.
By giving the subconscious mind’s auto pilot new directions, beliefs and goals toward which to move, you will experience success in areas you were never able to achieve in before. The stimuli to erratic behaviors, addictions, biases, defensiveness, anger, limitations, and pain will be removed and replaced with a healthy ego structure, life enriching beliefs and frames of reference. With the removal of the old false beliefs and the behaviors based on them, feelings about self worthiness automatically come from rescripted encouraging programs instead of the prior dysfunctional ones. Change becomes easy, successful and permanent. Following up the session with healthy conscious languaging is very helpful for your conversion process and will cause spontaneous changes in your attitudes and moods. Thank you for your full participation in the process.