Name *
Date
Issue / reason for hypnotherapy session?
Have you been listening to your recording (as recommended)?
Prior to your session, your issue rated
on a scale of 1 – 10; what does it rate now?
How do you feel about your issue now?
On intake, you described your desired results as being
Do you think you’ve achieved those results since your RTT session?
Overall, do you think RTT has been beneficial to you with regards to your issue? How?
Is there anywhere, RTT did not live up to your expectations?
Is there anywhere, I (the therapist) did not live up to your expectations?
Would you recommend hypnotherapy is a viable (natural, holistic, alternative) treatment to any issue?
