19. Adult New Return Intake Form Questions
1. Question: First Name
Why do we ask this? Your full name helps us personalize your therapy experience and ensures we have accurate records.
2. Question: Last Name
Why do we ask this? Your full name helps us personalize your therapy experience and ensures we have accurate records.
3. Question: Email
Why do we ask this? Your email allows us to send you your personalized session files and any helpful resources related to your therapy.
4. Question: Mobile Number
Why do we ask this? Your mobile number allows us to send you your personalized session files and any helpful resources related to your therapy.
5. Question: Please describe the new issue you’d like to work on?
Why do we ask this question? A detailed description helps us understand your new concern and prepare an appropriate therapeutic approach.
6. Question: How long have you been experiencing this new issue?
Why do we ask this question? The duration of the issue helps us determine if it’s a recent development or a long-standing concern, which informs our approach.
7. Question: On a scale of 1-10, how much does this new issue impact your daily life?
Why do we ask this question? This rating helps us understand the severity of the issue and prioritize our focus accordingly.
8. Question: Have you been practicing self-hypnosis or other techniques we gave you in previous sessions? If yes, how has that been going?
Why do we ask this question? Your experience with self-practice helps us understand what’s working for you and where you might need additional support.
9. Question: Is there any particular technique or approach from your previous session(s) that you found especially helpful or would like to explore further?
Why do we ask this question? This information helps us build on techniques that resonate with you and refine our approach.
10. Question: Have you or your child tried any strategies to address this new issue on your own? If yes, please describe:
Why do we ask this question? Knowing what you’ve already tried helps us build on your efforts and avoid repeating ineffective strategies.
11. Question: How do you think this new issue relates to (if at all) the previous issue we worked on?
Why do we ask this question? Understanding connections between issues helps us provide a more holistic and effective treatment approach.
12. Question: What are your expectations for addressing this new issue with hypnotherapy?
Why do we ask this question? Your expectations help us ensure we’re aligned in our approach and can address any misconceptions about the process.
13. Question: What specific goal(s) would you like to achieve in this upcoming session regarding this new issue?
Why do we ask this question? Clear goals help us structure the session to meet your immediate needs and expectations.
14. Question: Has any of your medical information changed since your previous session?
Why do we ask this question? Changes in your medical condition or medications can affect your overall well-being and may influence our therapeutic approach.
15. Question: Is there anything else you think would be important for your child’s therapist to know?
Why do we ask this question? This open-ended question allows you to share any additional information you feel is relevant to your child’s care.