Information Package


Intake Form

Please complete this before the appointment.

Complete Form


Confidential Information

Please print, complete and sign this and bring to your appointment.

Download Confidential Information Document


Terms of Acceptance

Please print, read and sign this to bring this to the appointment.

Download Terms of Acceptance Document


Times You Smoke and Reasons For Quitting

Please print and complete this to bring to your appointment.

Download Times and Reasons Document


Ideas To Replace Cigarette Smoking

Please print, add your ideas and bring to your appointment.

Download Ideas To Replace Cigarette Smoking Document


Pre-Session Action Plan

Please read this document before your appointment, making sure you follow the links it contains. Keep for reference later.

Download Pre-Session Action Plan


Emotional Assessment Form

People often cigarettes act like a crutch for them. Letting them go can cause a release of emotional challenges. So it is important we capture those areas and are aware of them prior to quitting smoking so they can be addressed.  Fill out this form and bring it n with you when you come for your session.

Download Ideas To Replace Cigarette Smoking Document


Listen to these two Audios

The first one is an actual stress relief self-hypnosis and an introduction to hypnosis that is fun and informative. You can listen to the first track in the car or when you are doing your work. However for the second one you will need a quiet space where you can relax and enjoy the experience of hypnosis.

Listen to the two audios on the website