Fill Out the Intake Form Before Your First Appointment

Sessions with Atwood Hypnosis may be video taped, and become part of your confidential record.

Any appointment changes need to be made two business days in advance. Appointments broken or canceled without the two business days’ notice will be charged for the session.

Client Signature

Upload File

*Parent/Guardian Signature (Signature is required if client is under 18 years old)

Upload File

*If you wear HARD contact lenses, please remove them before your session, as they inhibit your ability to relax.

This site is protected by reCAPTCHA. Google's Privacy Policy and Terms of Service apply.

971-340-2020

Client Bill of Rights

971-340-2020

Client Bill of Rights

Content, including images, displayed on this website is protected by copyright laws. Downloading, republication, retransmission or reproduction of content on this website is strictly prohibited. Terms of Use | Privacy Policy

Fill Out the Intake Form Before Your First Appointment

We find it useful to sometimes use a holistic approach (mind-body-spirit) when appropriate.

Medical History