Life History Questionnaire
The purpose of this questionnaire is to obtain a comprehensive picture of your background. By completing these questions, as fully and as accurately as you can, you will provide your hypnotherapist with important information, without using your actual therapy time. The information in this questionnaire will be kept by your hypnotherapist and will not be disclosed to anyone without your written permission. Case records are strictly confidential. If a question doesn't pertain to you, leave the field blank. If you do not wish to answer a question, simply write: do not care to answer.