Ontario Hypnotherapy Centre.
Helping you to become your best self.
Hypnosis and Hypnotherapy tailored for the individual.
Please fill out all fields and be as honest as possible with your answers
Name*
Address/Telephone Number*
Sex*
Age*
Email Address*
How did you hear about us?*
Have you been hypnotized previously? How did it go?*
Reasons for coming for hypnotherapy*
Have you attempted to address this issue before? What were the results?*