Registered client? Sign in
Service:Hypnosis - Follow-Up (In-Office) add another, change
Practitioner: Jodi Grubman change
Date/time:Thu, Jun 8 2023 at 12:00 PM (CDT) change

Please read carefully before scheduling:

  • Please double-check the date/time and time zone above before booking
  • 48 hour notice is required to cancel an appointment to avoid the full session fee being due
  • New clients must complete the New Client Information Form a minimum 2 days in advance (link displayed after confirming your appointment and in the confirmation e-mail). 
  • New clients who fail to complete the intake form and/or submit payment a minimum of 48 hours in advance are subject to cancellation. 
  • If your appointment is scheduled in less than 48 hours, please complete the intake form immediately to avoid cancellation.

  • Please check your e-mail after finishing this form for a confirmation link (required)

Please do not submit any Protected Health Information (PHI)

Registered user? Sign in
First name*
Last name*
Email*
Phone*
Birthday*
How did you hear about us?*
Notes*
Please include details about the topic you wish to work on/improve
Street address*
City, state, zip*
* required field