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YOUR FREE EMOTIONAL WELLBEING ANALYSIS

Where are you right now?  Do you need therapy?  Would it help you?

Do you have too much stress in your life?  Are there wounds from the past you need to heal? Is your mental attitude affecting your health? How do you feel about love and relationships? Are you programmed for success? Complete and return this questionnaire to find out where you are emotionally, what you need right now and which therapies and life choices will bring you the best results at this time in your life.

Your can highlight or place a 'yes' or 'no' and/or give more details next to comments that apply to you. Simply cut and paste this questionnaire into an e-mail, (posted to the link below) complete and return it to me via the e-mail (if you prefer to post, a small charge may be required for return postage). Include any further questions you have, with your e-mail. You will receive a FREE E-MAIL REPORT with advice and insights into your personality and temperament and details of your best therapies. Please note that your completed questionnaire and all answers are strictly confidential. Your name and address are optional, include these only if you require more information of special offers etc.   E-mail me if you are not sure how to complete this questionnaire or with any other questions. Please allow one week for your report and a little extra during holiday periods. Feel free to leave out any questions/statements you are not sure about.

 

Name ......................................................................................

E-mail .....................................................................................

Address (optional) ..............................................................................................................................................................

............................................................................................................................................................................................

Are you male or female? .........................................................................................................

Date, time and place of birth  .................................................................................................

 

1) Colour test

Write down the following colours with their numbers in order of preference, starting with your favourite and ending with your least favourite colour. Make your choices from the screen rather than a print out.

My chosen colours are (in order):

 

 

2. Colour test 2

Now write down the following more detailed colours in order of your preference:

Red, Magenta, Crimson, Deep pink, Light Pink, Peach, Orange, Yellow, Gold, Lime Green, Dark Green, Peacock Green, Turquoise, Indigo blue, Royal blue, Light blue, Deep Violet, Light Lavender Purple, Dark Purple, Black, Medium Grey, Light Grey, Silver, White.

2. Health and vital energy test

a) Where do you feel most tension in your body?

b) Please give details of any health conditions or discomfort you are experiencing in your body at this time. Diagnosed conditions or otherwise. For example, stomach ache, sleeplessness, headaches when tense, eye problems etc. Please state how your body feels from day to day or if you have problems in any of the following areas/organs. Scan your body mentally. Give details below: You can also mention complaints that occur from time to time or when you are under stress.

Head, Ears, Eyes, Nose, Neck, Chest, Stomach, Small intestine, Large intestine, Gall bladder, Liver, Kidneys, Pancreas, Other, Shoulders, Arms, Legs, Knees, Feet, Skin, Bones, Blood.

3. Psychological background

a: Have you had any psychological therapies before?

b) Did they help? (give details)

4. Therapy questionnaire

You would consider yourself sceptical

You have had hypnotherapy and it worked well

You have had hypnotherapy and it did not work for you

You do not know about hypnotherapy and need someone to clarify it for you.

You know hypnotherapy is an excellent self change tool

You have habits you want to change

You need to stop smoking

You need to lose weight

You have phobias

You have allergies

You have addictions to:

Food

Alcohol

Smoking

Something else (give details)

You find it difficult to relax

You find it difficult to sleep

Your life is so far from how you want it to be

You need more self confidence

You have panic attacks

You feel anxious

You have experienced or are experiencing depression

You are experiencing grief

You cannot forget something from the past

You find it easy to visualise

You find it impossible to visualise

You have vivid and interesting dreams

You often feel you are too busy to get things done

Routine is difficult for you

You find it hard to make commitments

You would find it hard to listen to CD recordings between sessions

You like things to be quick and user friendly.

You like something you can do for yourself as and when you need it

You have problems making or keeping money

You undervalue yourself

You had a difficult birth

You had a unhappy childhood

You were not given affection/attention by one or both parents (give details)

You were bullied at school/college

You have one or more allergies

You have one or more phobias

You were adopted

You suffered mental or physical abuse as a child

You keep thinking about the things that people have said or done to you

You find it hard to forgive

You find it hard to love

You are still attached to someone who is not right for you

You attract the 'wrong types'

You want to improve your friendships

You find it hard to let go of the past

You have had relationship problems or breakups

You feel the odd one out in a group

You want to stop making the same mistakes over and over

You feel you need to change yourself to be happy

You needed love and support in the past and did not get it at important times

You would like to comfort your inner child

You do not remember a lot of your childhood

You believe that we live on after death

You don't believe in reincarnation

You are a sceptic and a scientist

You are often intuitive and psychic

You feel you have a special mission in life

You don't know why you are here

You feel a distinct connection with a place or places you have never visited

You have always had a reaction to a certain period in history that you cannot explain

You have strong religious beliefs (please state religion)

You are not religious

You feel like you come from another planet sometimes

You feel you are here for a purpose

You feel destructive for no reason

You self sabotage

People accuse you of things you have not done and have no memory of

You have had your fortune told in the past

a)  you were impressed

b) you were not impressed

You do not believe you can visit past or future lives

You are fascinated by the idea of visiting past and future lives

You have made big mistakes in the past

You have a big choice coming up regarding

a) a relationship

b) a big life change

c) a house move

d) a holiday

e) your career

f) a business

g) something else

You have been made redundant or unemployed and need to explore your options

You do not know what kind of work you should be doing

You once had a trauma and have still not fully recovered

You feel you have a missing period from your life

You have never been the same since a trauma or accident

 If you saw your abuser/s you would like to 'kick ass'

You would love to give someone a piece of your mind

You are fascinated by totem animals, spirit guides, angels and more.

You often feel that someone is guiding you and protecting you and would like to know more

You would love guidance on so many aspects of your life from someone wise and loving

You would really love to have all your questions answered by someone who knows

You have tried so many things and have decided to try hypnotherapy

You have heard so much about EFT and want to try it

You are interested in Past Life Therapy  

You are interested in Future Life Progression

You have are interested in Inner Child Therapy

You are interested in Matrix Reimprinting

How did you hear about True Nature Hypnotherapy (state reply here)

You are ready to change

You are interested in my therapies and would like to know more

 You are determined and willing to work hard to improve your life

You are able to work by Skype

You can only work by phone but could be happy to listen to CDs regularly and do homework

You are male/female

Please state your age and location

You can attend sessions in person in the Cheshire, UK area

You do not feel the need for therapy at this time but would like to read your report.

Would you like to join my mailing list? (you can unsubscribe at any time)     

Any further information

 

Please paste this into a document or e-mail, complete it by highlighting your answers (or stating yes or no)

and e-mail it to me for your free e-mail report.  If you are unable to cut and paste it, simply e-mail me and I will send it to you.

Please note, you will not be added to a mailing list unless requested.