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Questions for change

Please fill out as much as you can. The more information we have the better we are able to help you.

Name*

List 7 benefits of changing this unwanted behaviour

Do you often feel you should be punished for past actions

Is there a past/current relationship that may be causing this problem

Are you aware of an internal conflict that may be Causing all (or part) of this problem

If you have any questions about this form or Hypnosis please ask them here


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