Hypnotherapy Intake

Welcome

I am excited to share the science and art of hypnotherapy with you. Hypnotherapy is a powerful tool for changing thoughts, feelings and behavior. Although it can significantly ease and accelerate the process of change, effort and practice on the part of the client are key for success.

Your sessions will be custom-tailored from the information you provide. If you have a specific interest, you can let me know. I am committed to creating a compassionate and productive space for your transformation.

You can reach out by phone or email anytime, even after your sessions are complete. Most questions can be answered quickly and easily. If you have a more in-depth question, we can discuss it during your session. Please know that your progress is always welcome.

Krystal Matocha, CHT
krystal@thewholemeasure.com
Call (928) 421.2427

Step 1

A medical referral may be required if you are using hypnotherapy for pain management, mental illness or medical issue.

If needed, download the form and have your physician complete. Then return it to me.

Step 2

Review the cancel and preparation policy:

  • Same day cancellations and no-shows are subject to a cancel fee equal to price of session.
  • Wear clothes you can relax in.
  • Your session will last approximately 1 hour. If you have a time constraint, let me know before we start.
  • For virtual sessions, set-up a peaceful place free of distraction. Although animals can be comforting, they can also be distracting so please keep them in a separate room during your session. You also might enjoy a blanket.

Step 3

Complete the 15 minute intake form.

If you prefer, you may request a PDF form to complete and return by email or postal mail.

Intake Form

Statement of Acceptance: I am of legal age and I am aware that this program is non-medical in nature and for any prescription, diagnoses or treatment I will consult my physician or medical doctor. If the purpose for receiving hypnosis is a medical issue, I understand I must obtain my physician’s approval to use hypnosis as an adjunct to medical treatment. I understand this is an acknowledgement of my agreement to participate in hypnosis. Further I acknowledge that hypnosis is a potentially powerful mental and physical regulating tool. I understand that personal results and timing may vary and that there are no expressed or implied guarantees or warranties of results. I understand that hypnosis is a collaborative experience between client and practitioner, and requires a desire and commitment to succeed in order to be effective.