Fun Photos, Proud Moments and Memories from Wise Mind Hypnosis

Wise Mind Hypnosis, 4250 Hempstead Turnpike, Suite 9, Bethpage NY 11803 | Office: 516-933-3669

First Name*
Last name*
Email
Phone
Briefly describe the issue or challenge that led you to seek hypnosis services?*
What else have you tried, if anything, to overcome this issue?*
What has been holding back your ability to achieve this goal?*
Why are you ready NOW to make a change?*
What will the benefits be in your life as a result of achieving this goal?*
Achieving the best version of you requires an investment of time, energy and money. Are you ready and able to commit to the time, money and energy toward the outcome you desire?*
- Yes, I am willing to make the commitment to myself and feel better.
- No, I am not quite ready yet to take the steps.
Please share any questions or notes you think I should know of in advance*
Kindly note hypnosis programs at Wise Mind Hypnosis are not covered by insurance.

Donna is committed to helping you to feel your very best. She will call you with 2 business days to schedule your complimentary 20-minute strategy call.
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