I’m Sherris, Your Transformational Guide. Thank you for your interest in working together! This form helps me understand if we're a good fit for deep transformational work.

VIP 1-1 sessions require an investment of time and money and may not be suitable for those on a strict budget. I currently work with clients through 3- or 6-month renewable packages that give us the time and space to drive real, lasting change.

Please answer as openly and honestly as you can. There are no wrong answers; this is simply to help us both determine whether this is the right time and approach for your healing journey.
BASIC INFORMATION

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* 1. Full Name:

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* 2. Email Address:

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* 3. Phone Number:

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* 4. Location/Timezone:

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* 5. Preferred pronouns:

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* 6. How did you hear about my work?

ARE YOU AN EMPATH OR HIGHLY SENSITIVE PERSON?

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* 7. Do you identify as an empath, highly sensitive person (HSP), or creative intuitive?

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* 8. Which of these experiences resonate with you? (Check all that apply)

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* 9. In your own words, how would you describe your experience of being sensitive or empathic?

WHAT BRINGS YOU TO HYPNOTHERAPY NOW?

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* 10. What is happening in your life at present that prompts you to seek hypnotherapy?

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* 11. What do you hope to achieve in our work together?

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* 12. Are there specific patterns, wounds, or blocks that you want to heal or transform?

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* 13. Is there a particular event, realization, or "last straw" that made you decide to seek help now?

YOUR HEALING JOURNEY SO FAR

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* 14. Have you worked with any of the following? (Check all that apply)

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* 15. For any you've tried, what worked well? What didn't work?

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* 16. Are you currently working with any other practitioners or therapists? If yes, please share the kind of work you are doing together.

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* 17. Is there anything from your past healing journey that you think I should know?

READINESS & COMMITMENT

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* 18. I work with clients through 3-month or 6-month packages so we can create lasting change. Are you ready to commit to this depth and duration of transformational work to begin?

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* 19. If you have concerns or questions, please share them:

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* 20. What support systems do you have in place? (Friends, family, community, etc.)

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* 21. Is there anything happening in your life right now that might interfere with your ability to show up consistently for this work? (Major life transitions, work demands, health concerns, etc.)

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* 22. On a scale of 1-10, how ready do you feel to do deep inner work right now?

1 (not ready) 10 (completely ready)
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i We adjusted the number you entered based on the slider’s scale.

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* 23. What makes you feel you're at that level of readiness?

UNDERSTANDING THE WORK

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* 24. Have you experienced hypnotherapy before?

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* 25. If yes, what was that experience like?

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* 26. Do you have any concerns or fears about hypnotherapy?

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* 27. What questions do you have about working together?

FINAL THOUGHTS

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* 28. Is there anything else you'd like me to know about you, your situation, or what you're hoping for from our work together?

NEXT STEPS
Thank you for taking the time to complete this intake form. I'll review your responses and reach out within 2-3 business days with your next best steps.

I'm honored that you're considering this journey with me.

With gratitude, Sherris

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