22. Child New 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: Parent/Guardian’s First Name
Why do we ask this? Your name as the parent or guardian helps us identify the primary contact for communication about your child’s therapy.
5. Question: Parent/Guardian’s Last Name
Why do we ask this? Your name as the parent or guardian helps us identify the primary contact for communication about your child’s therapy.
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: Please describe the new issue your child would like to work on?
Why do we ask this question? A detailed description helps us understand your child’s new concern and prepare an appropriate therapeutic approach.
9. Question: How long has your child 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.
10. Question: On a scale of 1-10, how much does this new issue impact your child’s daily life?
Why do we ask this question? Understanding the severity of the issue and its impact helps us gauge its importance in your child’s life.
11. 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? Your child’s experience with self-practice helps us understand what’s working for them and where they might need additional support.
12. 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.
13. 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? Knowing what you’ve already tried helps us build on your efforts and avoid repeating ineffective strategies.
14. Question: How do you think this new issue relates to (if at all) the previous issue we worked on?
Why do we ask this? Understanding connections between issues helps us provide a more holistic and effective treatment approach.
15. Question: What are your expectations for addressing this new issue with hypnotherapy for your child?
Why do we ask this? Your expectations help us ensure we’re aligned in our approach and can address any misconceptions about the process.
16. Question: What specific goal(s) would you like your child to achieve in this upcoming session regarding this new issue?
Why do we ask this? Clear goals help us structure the session to meet your child’s immediate needs and expectations.
17. 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.
18. 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.