QHHT Form

First Name

Last Name

Email Address

Have you tried hypnosis before? Have you tried hypnosis before?YesNo

Why you need this session? Please provide your 3 questions that you want to ask during this session. Eg: Why am I stuck with my life? What is my life's purpose? Am I following my soul's purpose? I want to quit my job, how can I transition?

Have you had Past Life Regression before? Yes/No Have you had Past Life Regression before? Yes/NoYesNo

Face to Face: Face to Face: I confirm that QHHT is a face to face session.

Session Length: Session Length: I am aware that the session can take at least 4 hours.

Age and Diagnoses: Age and Diagnoses: I can confirm that I am over 17 years old and I am NOT diagnose with Alzheimer or Schizophrenia.

Terms and Conditions and Privacy Policy: Terms and Conditions and Privacy Policy: I agree and understand the Terms and Conditions and Privacy Policy. I agree to fully release and hold harmless, Flora Mae Stafford (Growth Teacher) from and against any all and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).

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