I am not scheduling clients in the office due to covid-19 and a family member's serious health challenges until well into 2022. I am sorry. But I am still working online via ZOOM and am offering a discount for online sessions even though my clients tell me that the ZOOM sessions are highly effective - like an office visit in your home.

*** Click here to begin making your Survey! ***

* Please provide your name and address
0/50
* What is your email address?
0/50
Please list the year of your birth:
0/50
* Are you interested in an online (ZOOM) or in office appointment?
0/250
* How did you first hear of me and my practice?
0/250
* Have you been hypnotized before?
0/250
Are you or have you been in counseling with a therapist.
* What is your primary change you wish to make with hypnotism today?
0/250
Please let me know what YOU know about hypnotism. Check all that seem INCORRECT (NOT TRUE) to you. Add any comments or questions in the "other" box at the bottom of this question.
0/250
Please provide any background that you are comfortable sharing here. Include any other methods you may have tried to address the issue and why you have decided NOW is the time to make a change. Be as thorough or brief as you wish. Leave blank if the issue is sensitive and you prefer to talk further over the phone or in the office.
0/500
Please check any fears you have.
0/250


CLIENT "BILL OF RIGHTS" 

Please read carefully before you complete this intake form.

 

All conversations and transactions between hypnotist and client are confidential and will not be disclosed except by the client's written authorization.

The length, content and approach of each session are to be agreed upon prior to the hypnotic consultation. It is the client's right to know the estimated number of sessions recommended to achieve his or her goals. It is the client's right to file a complaint with the National Board of Hypnotists, Ethics Committee, Merrimack, NH as well as any state agency. It is the client's right to refuse any process by his or her own determination and to end hypnotherapy whenever he or she wishes with a pro-rated refund. It is the client's right to have the name of other practitioners in the community who may be available to work with him or her. Note: John Koenig is a Board Certified Hypnotist and is certified and trained to instruct new professional hypnotists (National Guild of Hypnotists).


John is a Board Certified Hypnotist and a Certified Hypnotist Instructor with the National Guild of Hypnotists.


He is not a medical doctor or licensed psychologist, psychotherapist, social worker, dietition or nutritionist and does not diagnose or treat any illness. He holds a Bachelor of Arts Degree in Psychology (Hofstra University, Hempstead, NY) and a Master of Arts Degree earned at the National University of Ireland (Dublin, Republic of Ireland).