21. Child Continue Return Intake Form Questions
1. Question: Child’s First Name
Why do we ask this? Your child’s name allows us to personalize the self-hypnosis experience and maintain accurate records for their therapy.
2. Question: Child’s Last Name
Why do we ask this? Your child’s name allows us to personalize the self-hypnosis experience and maintain accurate records for their therapy.
3. Question: Child’s Date of Birth
Why do we ask this? Your child’s date of birth helps us calculate their exact age, which is crucial for tailoring the content and approach of the self-hypnosis materials to their developmental stage.
4. Question: First Name (Parent/Guardian)
Why do we ask this? We ask for your full name to personalize your therapy experience and ensure we have accurate records.
5. Question: Last Name (Parent/Guardian)
Why do we ask this? We ask for your full name to personalize your therapy experience and ensure we have accurate records.
6. 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.
7. Question: Mobile Number
Why do we ask this? Your mobile number provides a direct method for sending your child’s session and important communications about your child’s therapy.
8. Question: What progress have you noticed in your child since their last session?
Why do we ask this? Your perception of your child’s progress helps us understand what’s working well and what areas might need more attention.
9. Question: On a scale of 1-10, how would you rate your child’s progress towards their original goal?
Why do we ask this? This rating helps us quantify your child’s progress and adjust our approach if needed.
10. Question: What aspects of your child’s previous issue would you like to focus on in this session?
Why do we ask this? Your input helps us tailor the session to address the areas you feel are most important for your child right now.
11. Question: What specific goal would you like your child to achieve in this upcoming session?
Why do we ask this? Clear goals help us structure the session to meet your child’s immediate needs and expectations.
12. Question: Has your child been practicing self-hypnosis or other techniques we gave them in previous sessions? If yes, how has that been going?
Why do we ask this? Your child’s experience with self-practice helps us understand what’s working for them and where they might need additional support.
13. Question: Is there any particular technique or approach from your child’s previous session(s) that they found especially helpful or would like to explore further?
Why do we ask this? This information helps us build on techniques that resonate with your child and refine our approach.
14. Question: Have there been any significant changes in your child’s life since the last session? (e.g., school, family, health)
Why do we ask this? Life changes can significantly impact your child’s well-being and may require adjustments to our therapeutic approach.
15. Question: Has any of your child’s medical information changed since their previous session?
Why do we ask this? Changes in your child’s medical condition or medications can affect their overall well-being and may influence our therapeutic approach.
16. Question: Is there anything else you think would be important for your child’s therapist to know?
Why do we ask this? This open-ended question allows you to share any additional information you feel is relevant to your child’s care.