Registration form
Dear Client,
Your hypnosis appointment is initially marked, but not yet bindingly booked. For the booking I need some important information from you.
Your details, as well as the contents of the session, will of course be treated confidentially. Please fill in all fields and click on “send” at the end of the form. Please make sure that “The message was successfully submitted” is displayed in your browser window at the end. It is advisable to prewrite the longer texts in a word processing program and then copy them over so that the content is not lost in case of technical problems. If you have any problems with sending me the email, there is a Word document at the end of this page, which you can download and send to me by email.
If the information is too sensitive for you to submit online here, you can also print out the form and mail it to my office address or drop it off in person. The practice’s letterbox is located in the entrance area of the medical centre and is only accessible during the day.
You will then receive a binding confirmation of your session by email. If you do not receive an email within two working days, please call me!
Feel free to take some time to fill it out, it’s part of your preparation!
I am looking forward to your registration!
Fields marked with * are mandatory
