Happiness Now Intake Form - Please compete prior to your appointment

DEMOGRAPHICS
Name *
Name
Date of Birth *
Date of Birth
WHAT WOULD YOU LIKE TO HAVE HAPPEN?
HEALTH
HYPNOSIS
PAYMENT AND FEES - Fees and payment are due at the time of service

Policies:
When you make an appointment that time period will be reserved for you only. We do not over book in case of cancellations and rescheduled appointments. 24 hrs notice is required to cancell or reschedule an appointment. Unless you give 24 hours notice of a cancellation or to reschedule your appointment you will be charged for the entire session. That session will count as one of your package sessions if you purchased a package.