Miami Valley Hypnosis

Consultation

Our screening is fun and informative. We explain hypnosis, evaluate your situation, suggest a fee and a program that meets your needs. There is no pressure. If we feel hypnosis won't help you we will tell you so.

It's easy to get started. Just tell us about yourself and our staff will contact you to schedule your FREE no obligation hypnotic screening and evaluation.

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Name

Street Address

City

State

Zip Code

Work Phone

Home Phone

E-mail

What would you like to accomplish with hypnosis?

* Some programs require a physician referral.

Have you heard about Miami Valley Hypnosis on the radio?
yes no

Have you heard about Miami Valley Hypnosis on the television?
yes no

Have you heard about Miami Valley Hypnosis in the newspapers?
yes no

Have friends or family members used our services?
yes no

Did your doctor recommend our services?
yes no