Ellie’s Favorite Five - Hypnosis Intake Forms
Sunday, December 2nd, 2007Since one of the subjects that we are focusing on are intake forms, I have included links for Ellie’s favorite five intake forms. They are all very different, but worth sharing. There is a lot one can learn by looking at these.
- Harwell Hypnosis & Healing - Janet Harwell’s intake form is very inclusive and makes a point of mentioning the comfort process, in other words, does the client wear contacts and is it a problem to have one’s eyes closed for a 45 minutes or more duration. It also ask about hearing problems (brilliant) and if the client would like any religious references mentioned. It is available online as a word document or a PDF.
- Advanced Hypnotherapy Services - Rex A. Jones’s intake form is a three page PDF download. It includes a disclosure and consent form for hypnosis/hypnotherapy, client history and medical background, and a client consulting agreement that both Rex and the client signs. This is very straight forward and basic, but the addition of the disclosure and agreement as a nice touch of professionalism.
- Insyht Hypnotherapy - Natasha Khachaturian has her intake form as a form to be filled out online. It asks both medical information and questions about the client’s goals and has great functionality to it.
- Addison Hypnosis Center - John Evans’ intake form is short and sweet. I love the questions “What are you doing, feeling, thinking or saying to yourself that you would like to change?” and “What experience would you like to be having instead?” This is a text format download.
- Vital Voice - Joanne Padawer’s intake form blew me away. It is a 12 page download, but talk about thorough. Six pages are typical hypnosis intake questions with a fair amount of space to give answers. It also includes a stress level profile, a challenges checklist, and a release statement.


