Custom Hypnosis Script Intake Form

Please complete the following form so I can tailor your custom hypnosis script accurately and efficiently.

First Name

Last Name

What type of script are you ordering?

Client’s Main Issue or Goal (e.g., public speaking, weight loss, confidence, etc.)

What type of approach would you like included?

Preferred tone of voice?

If 'Other', please specify:

Any specific details, phrases, or metaphors you'd like included (optional):

Preferred script length?

If you'd like it to match your usual format, please describe:

Would you like a wake-up/return to alertness included?

Any additional notes, special requests, or client background I should know: